Standard and emerging CMR methods for mitral regurgitation quantification

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:331

Article

Fidock, Benjamin¹  Archer, Gareth¹  Barker, Natasha¹  Elhawaz, Alaa¹  Al-Mohammad, Abdallah^1,2  Rothman, Alexander¹  Hose, Rod¹  Hall, Ian R.²  Grech, Ever²  Briffa, Norman^1,2  Lewis, Nigel^1,2  van der Geest, Rob J.³  Zhang, Jun-Mei⁴  Zhong, Liang⁴  Swift, Andrew J.¹  Wild, James M.¹  De Garate, Estefania⁵  Bucciarelli-Ducci, Chiara⁵  Bax, Jeroen J.³  Plein, Sven⁶  Myerson, Saul⁷  Garg, Pankaj¹ 

[1] Univ Sheffield, Sheffield, S Yorkshire, England

[2] Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, England

[3] Leiden Univ, Med Ctr, Leiden, Netherlands

[4] Natl Heart Ctr Singapore, Singapore, Singapore

[5] Bristol Heart Inst, Bristol, Avon, England

[6] Univ Leeds, Leeds, W Yorkshire, England

[7] Univ Oxford, Oxford, England

关键词: Mitral valve insufficiency;    Reproducibility of results;    Magnetic resonance imaging;   

DOI  :  10.1016/j.ijcard.2021.01.066

来源: Elsevier

【 摘 要 】

Background: There are several methods to quantify mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR). The interoperability of these methods and their reproducibility remains undetermined. Objective: To determine the agreement and reproducibility of different MR quantification methods by CMR across all aetiologies. Methods: Thirty-five patients with MR were recruited (primary MR = 12, secondary MR = 10 and MVR = 13). Patients underwent CMR, including cines and four-dimensional flow (4D flow). Four methods were evaluated: MRStandard (left ventricular stroke volume-aortic forward flow by phase contrast), MRLVRV (left ventricular stroke volume - right ventricular stroke volume), MRJet (direct jet quantification by 4D flow) and MRMVAV (mitral forward flow by 4D flow - aortic forward flow by 4D flow). For all cases and MR types, 520 MR volumes were recorded by these 4 methods for intra-/inter-observer tests. Results: In primary MR, MRMVAV and MRLVRV were comparable to MRStandard (P > 0.05). MRJet resulted in significantly higher MR volumes when compared to MRStandard (P < 0.05) In secondary MR and MVR cases, all methods were comparable. In intra-observer tests, MRMVAV demonstrated least bias with best limits of agreement (bias = -0.1 ml,-8 ml to 7.8 ml, P = 0.9) and best concordance correlation coefficient (CCC = 0.96, P < 0.01). In inter-observer tests, for primary MR and MVR, least bias and highest CCC were observed for MRMVAV. For secondary MR, bias was lowest for MRJet (-0.1 ml, P=NS). Conclusion: CMR methods of MR quantification demonstrate agreement in secondary MR and MVR. In primary MR, this was not observed. Across all types of MR, MRMVAV quantification demonstrated the highest reproducibility and consistency. (C) 2021 The Author(s). Published by Elsevier B.V.

【 授权许可】

Free