Key result
3D echocardiography and cMRI show the best agreement for grading regurgitant severity despite poor cross-modality correlation.
Why the study?
The feasibility of quantitative volumetric and semi-quantitative approaches for quantifying chronic aortic regurgitation using different imaging modalities was unclear.
How do 2D echocardiography, 3D echocardiography, and cardiac MRI compare in quantifying chronic aortic regurgitation?
Observational (n=55)
How do 2D echocardiography, 3D echocardiography, and cardiac MRI compare in quantifying chronic aortic regurgitation?
Quantitative volumetric assessment of aortic regurgitation by 3D echocardiography and cMRI shows better agreement for severity grading than 2D echocardiography, though absolute values correlate poorly across modalities.
Answers are grounded in this paper and cite their sources.
Volumetric RF quantification appears feasible across modalities in chronic AR; leaves open whether it improves grading consistency over semi-quantitative methods.
Purpose The study compares the feasibility of the quantitative volumetric and semi-quantitative approach for quantification of chronic aortic regurgitation (AR) using different imaging modalities. Methods Left ventricular (LV) volumes, regurgitant volumes (RVol) and regurgitant fractions (RF) were assessed retrospectively by 2D, 3D echocardiography and cMRI in 55 chronic AR patients. Semi-quantitative parameters were assessed by 2D echocardiography. Results 22 (40%) patients had mild, 25 (46%) moderate and 8 (14%) severe AR. The quantitative volumetric approach was feasible using 2D, 3D echocardiography and cMRI, whereas the feasibility of semi-quantitative parameters varied considerably. LV volume (LVEDV, LVESV, SVtot) analyses showed good correlations between the different imaging modalities, although significantly increased LV volumes were assessed by cMRI. RVol was significantly different between 2D/3D echocardiography and 2D echocardiography/cMRI but was not significantly different between 3D echocardiography/cMRI. RF was not statistically different between 2D echocardiography/cMRI and 3D echocardiography/cMRI showing poor correlations (r < 0.5) between the different imaging modalities. For AR grading by RF, moderate agreement was observed between 2D/3D echocardiography and 2D echocardiography/cMRI and good agreement was observed between 3D echocardiography/cMRI. Conclusion Semi-quantitative parameters are difficult to determine by 2D echocardiography in clinical routine. The quantitative volumetric RF assessment seems to be feasible and can be discussed as an alternative approach in chronic AR. However, RVol and RF did not correlate well between the different imaging modalities. The best agreement for grading of AR severity by RF was observed between 3D echocardiography and cMRI. LV volumes can be verified by different approaches and different imaging modalities.
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Stoebe et al. (2018) conducted an observational in Chronic aortic regurgitation (n=55). Quantitative volumetric assessment (2D/3D echocardiography and cMRI) vs. Semi-quantitative assessment was evaluated on Correlation and agreement of regurgitant volume and regurgitant fraction between imaging modalities. Quantitative volumetric assessment of regurgitant fraction is feasible, but regurgitant volume and fraction correlated poorly across modalities, with the best agreement for grading severity found between 3D echocardiography and cMRI (k=0.62).
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