Key result
Cardiac magnetic resonance assessment of left ventricular end-diastolic volume better predicted regurgitation severity compared to standard echocardiography (AUC 0.78 for MR; AUC 0.91 for AR).
Why the study?
The study investigated the potential additional value of CMR compared to standard echocardiography for assessing LV dilatation and dysfunction in chronic left-sided valvular regurgitation.
Does cardiac magnetic resonance improve the assessment of left ventricular dilatation and dysfunction compared to standard echocardiography in patients with chronic severe left-sided regurgitations?
Observational (n=71)
Does cardiac magnetic resonance improve the assessment of left ventricular dilatation and dysfunction compared to standard echocardiography in patients with chronic severe left-sided regurgitations?
Effect estimate: AUC 0.78 for MR; AUC 0.91 for AR
p-value: p=0.011 for MR; 0.006 for AR
CMR assessment of left ventricular end-diastolic volume is more reliably associated with regurgitant volume than standard echocardiography in patients with chronic severe left-sided regurgitations.
PURPOSE: The purpose of this study was to investigate the potential additional value of cardiac magnetic resonance (CMR) in the assessment of left ventricular (LV) dilatation and dysfunction by comparison to standard echocardiography in patients with chronic left-sided valvular regurgitation. MATERIALS AND METHODS: We prospectively enrolled patients with chronic severe mitral regurgitation (MR) or aortic regurgitation (AR). They underwent standard echocardiography and CMR using aortic flow and LV-function sequences. LV dilatation or dysfunction was assessed with each technique, based on thresholds used for surgery indication. Reference regurgitation severity was defined following previously reported CMR-based regurgitant volume thresholds. RESULTS: A total of 71 patients with chronic severe MR (n=44) or severe AR (n=27) were prospectively included. There were 60 men and 11 women with a mean age of 61±14 (SD) years (range: 18-83 years). CMR-based regurgitation severity was significantly greater in the LV dysfunction group when assessed with CMR (MR, P=0.011; AR, P=0.006) whereas it was not different when LV dysfunction was assessed using standard echocardiography. Among standard echocardiography and CMR volumetric indices, CMR-derived end-diastolic volume showed the best ability to predict regurgitation severity (area under the curve [AUC]=0.78 for MR; AUC=0.91 for AR). Diagnostic thresholds identified on receiver operating characteristics-curve analysis were lower than those of current European recommendations and closer to North-American guidelines. CONCLUSION: CMR assessment of LV end-diastolic volume in chronic severe left-sided regurgitations is more reliably associated with CMR-based regurgitant volume by comparison with standard echocardiography diameter. CMR may provide useful evaluation before surgery decision for severe asymptomatic regurgitations.
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Capron et al. (2020) conducted an observational in Chronic severe left-sided valvular regurgitation (n=71). Cardiac magnetic resonance (CMR) vs. Standard echocardiography was evaluated on Prediction of regurgitation severity (AUC 0.78 for MR; AUC 0.91 for AR, p=0.011 for MR; 0.006 for AR). Cardiac magnetic resonance assessment of left ventricular end-diastolic volume better predicted regurgitation severity compared to standard echocardiography (AUC 0.78 for MR; AUC 0.91 for AR).
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