Does cardiovascular magnetic resonance (CMR)-derived aortic regurgitation fraction (ARF) > 33% predict adverse clinical outcomes and intervention timing in patients with aortic regurgitation?
CMR-derived aortic regurgitation fraction > 33% is strongly predictive of adverse clinical outcomes and can help guide intervention timing in patients with aortic regurgitation.
AIMS: Aortic regurgitation (AR) is a prevalent valvular disease. Cardiovascular magnetic resonance (CMR) imaging is emerging as an accurate and precise method for assessing AR. However, its role in guiding interventions and risk stratification for outcomes remains to be fully defined. OBJECTIVE: This systematic review and meta-analysis evaluate the predictive utility of CMR-derived AR fraction (ARF) in determining intervention timing and clinical outcomes. METHODS AND RESULTS: A systematic search identified observational studies assessing CMR-derived ARF in AR prognostication. Hazard ratios (HRs) for intervention timing, mortality, and heart failure were pooled using a random-effects model. Study heterogeneity (I² statistic) was assessed, and publication bias was evaluated using a funnel plot. A total of 1235 studies were screened, with 12 meeting the inclusion criteria. Eight studies (n = 1996 patients) were included in the meta-analysis. ARF severity thresholds ranged from 30 to 43% (mean 33.7%). Follow-up ranged from 2 to 5.1 years. The pooled HR for clinic outcomes with an ARF > 33% was 4.12 (95% CI: 2.31-7.34, P value 33% is associated with significantly increased risk, warranting its integration into clinical decision-making frameworks.
Bali et al. (Sat,) studied this question.
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