Key result
Volumetric echocardiography shows better agreement with MRI than PISA for quantifying secondary MR in HFrEF.
Why the study?
The study was conducted to compare the consistency of echocardiographic regurgitant volume and regurgitant fraction obtained by PISA and volumetric methods with MRI measurements in patients with secondary mitral regurgitation and reduced LV EF.
Does the volumetric echocardiographic method improve consistency with MRI for assessing secondary mitral regurgitation severity in patients with reduced LVEF compared to the PISA method?
Cross-Sectional (n=433)
No
Does the volumetric echocardiographic method improve consistency with MRI for assessing secondary mitral regurgitation severity in patients with reduced LVEF compared to the PISA method?
The volumetric echocardiographic method provides better agreement with MRI than the PISA method for quantifying secondary mitral regurgitation in patients with reduced ejection fraction.
Answers are grounded in this paper and cite their sources.
Echocardiographic Vmr/FR by PISA or volumetric methods warrant cautious use versus MRI in secondary MR with low EF; leaves open optimal quantification approach.
Objectives : to compare the consistency of echocardiographic Vmr and FR obtained by PISA and volumetric methods with Vmr and FR obtained by MRI in patients with secondary MR with reduced LV EF. Materials and methods . The analysis included data from 433 patients with secondary mitral regurgitation with reduced LV EF (less than 35%). The patients were divided into 2 groups: Group 1 – 286 patients with an average age of 64 ± 10 years, in whom the calculation of R vol and RF was carried out by the PISA method. Group 2 – 147 patients with an average age of 63 ± 11 years, in whom the calculation of R vol and RF was carried out by the volumetric method. Results . A moderate correlation was found between the indicators obtained by MRI and echocardiography, regardless of the method used, volumetric method R vol r = 0.54 p = 0.01 and RF r = 0.56, p = 0.01, PISA method R vol , r = 0.36, p = 0.01 and RF, r = 0.3, p = 0.01. The agreement in MR severity categorical scores between PISA and MRI was 27% in the diagnosis of severe mitral regurgitation and 50% in the diagnosis of moderate MR. The consistency in categorical MR severity scores between volumetric and MRI was 46% in the diagnosis of severe mitral regurgitation and 65% in the diagnosis of moderate MR. In the Bland–Altman analysis, the average difference in R vol between PISA and MRI was 7.6 ± 13 ml with coincidence limits (30; –25 ml), the average difference in R vol between volumetric and MRI was –2.5 ± 7.3 ml with coincidence limits (–12; 17 ml). Conclusions . MRI and echocardiography regardless of the method used have only a moderate correlation in the assessment of Rvol and RF in patients with secondary MR with reduced EF. The volumetric method may be the method of choice when calculating quantitative indicators of MR severity, as it has better agreement with MRI data compared to the PISA method.
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Базылев et al. (2023) conducted a cross-sectional in Secondary mitral regurgitation with reduced left ventricular ejection fraction (n=433). Volumetric echocardiographic method vs. PISA echocardiographic method and MRI was evaluated on Correlation of regurgitant volume (Vmr) between volumetric echocardiography and MRI (r = 0.54, p=0.01). The volumetric echocardiographic method demonstrated better agreement with MRI for quantifying mitral regurgitation volume (mean difference -2.5 ml) compared to the PISA method (mean difference 7.6 ml) in patients with secondary mitral regurgitation and reduced ejection fraction.
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