The regurgitant fraction values for aortic regurgitation grading using TTE, LSA-Doppler, and CMR correlated well, with mean RF values being 39 ± 16% with TTE, 35 ± 18% with LSA-Doppler, and 32 ± 20% with CMR (p < 0.037).
Do CMR and LSA-Doppler accurately grade aortic regurgitation severity compared to a multiparametric TTE approach in patients with native aortic valve regurgitation?
Modality-specific grading scales for aortic regurgitation are necessary because CMR and LSA-Doppler yield systematically lower regurgitant fraction values than multiparametric TTE.
Effect estimate: Mean RF values: TTE 39 ± 16%, CMR 32 ± 20%, LSA-Doppler 35 ± 18% (95% CI Not applicable)
p-value: p=<0.037
Abstract Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) are current standard for assessing aortic regurgitation (AR). Regurgitant fraction (RF) can also be estimated by Doppler examination of the left subclavian artery (LSA-Doppler). However, a comparison of AR grading scales using these methods and a TTE multiparametric approach as reference is lacking. We evaluated the severity of AR in 73 patients (58 ± 15 years; 57 men), with a wide spectrum of AR of the native valve. Using a recommended TTE multiparametric approach the AR was divided in none/trace (n = 12), mild (n = 23), moderate (n = 12), and severe (n = 26). RF was evaluated by LSA-Doppler (ratio between diastolic and systolic velocity–time integrals) and by CMR phase-contrast imaging (performed in the aorta 1 cm above the aortic valve); the grading scales were then calculated. There were a good correlation between all methods, but mean RF values were greater with TTE compared with LSA-Doppler and CMR (39 ± 16% vs. 35 ± 18% vs. 32 ± 20%, respectively; p 42%; and using LSA-Doppler: mild, 45%. RF values for AR grading using TTE, LSA-Doppler and CMR correlate well but differ in groups with mild and moderate AR when using a recognized multiparametric echocardiographic approach. Clinical prospective studies should validate these proposed modality adjusted grading scales.
Spampinato et al. (2020) studied Aortic Regurgitation (n=73). Transthoracic echocardiography (TTE), Cardiac Magnetic Resonance (CMR), Left Subclavian Artery Doppler (LSA-Doppler) vs. None was evaluated on Regurgitant Fraction (RF) values (Mean RF values: TTE 39 ± 16%, CMR 32 ± 20%, LSA-Doppler 35 ± 18%, 95% CI Not applicable, p=<0.037). The regurgitant fraction values for aortic regurgitation grading using TTE, LSA-Doppler, and CMR correlated well, with mean RF values being 39 ± 16% with TTE, 35 ± 18% with LSA-Doppler, and 32 ± 20% with CMR (p < 0.037).