Evaluation of Aortic Regurgitation in Congenital Heart Disease: Value of MR Imaging in Comparison to Echocardiography

Overview

Journal Pediatr Radiol

Specialty Pediatrics

Date 2007 Mar 28

PMID 17387466

Citations 15

Authors

Sebastian Ley

Joachim Eichhorn

Julia Ley-Zaporozhan

Herbert Ulmer

Jens-Peter Schenk

Hans-Ulrich Kauczor

Raoul Arnold

Affiliations

Soon will be listed here.

Abstract

Background: Evaluation of the severity and the follow-up of aortic insufficiency (AI) are important tasks in paediatric cardiology. Assessment is based on clinical and echocardiographic (ECHO) findings such as the configuration of the valve and the regurgitation fraction (RF).

Objective: The goal of this study was to evaluate MRI compared to ECHO for determination of clinical severity, valve morphology and RF.

Materials And Methods: Thirty patients (age 3-27 years) with mild-to-severe AI were evaluated by clinical examination, ECHO (2-D and Doppler), and MRI at 1.5 T (2-D true-FISP cine short axis, phase-contrast flow in the ascending aorta).

Results: Both methods identified 13 bicuspid and 17 tricuspid valves. Good correlations between ECHO and cine MRI were found for ventricular mass, stroke volume, and ejection fraction. A good linear correlation was found for the RF determined by ECHO and phase-contrast MRI (r = 0.7). The RF was 6% in mild AI, 17% in moderate AI, and 30% in severe AI. The different severity groups showed significantly different RF and it was possible to discriminate between clinical severity grades (P = 0.01).

Conclusion: ECHO and MRI showed good agreement in evaluating morphology and function of the left ventricle. The clinical severity of the disease can be evaluated correctly using MRI.

Citing Articles

Quantitative evaluation of aortic valve regurgitation in 4D flow cardiac magnetic resonance: at which level should we measure?.

Polacin M, Geiger J, Burkhardt B, Callaghan F, Valsangiacomo E, Kellenberger C BMC Med Imaging. 2022; 22(1):169.

PMID: 36167535 PMC: 9513957. DOI: 10.1186/s12880-022-00895-2.

Aortic regurgitation: multimodal assessment of quantification and impact.

Ncho-Mottoh M, Huttin O, Selton-Suty C, Scadi S, Filippetti L, Marie P Cardiovasc J Afr. 2022; 34(1):9-15.

PMID: 35265958 PMC: 10392807. DOI: 10.5830/CVJA-2022-013.

The cardiovascular determinants of physical function in patients with end-stage kidney disease on haemodialysis.

Adenwalla S, Billany R, March D, Gulsin G, Young H, Highton P Int J Cardiovasc Imaging. 2020; 37(4):1405-1414.

PMID: 33258084 PMC: 8026413. DOI: 10.1007/s10554-020-02112-z.

Aortic regurgitation assessment by cardiovascular magnetic resonance imaging and transthoracic echocardiography: intermodality disagreement impacting on prediction of post-surgical left ventricular remodeling.

Neisius U, Tsao C, Hauser T, Patel A, Pierce P, Ben-Assa E Int J Cardiovasc Imaging. 2019; 36(1):91-100.

PMID: 31414256 DOI: 10.1007/s10554-019-01682-x.

Left ventricular mass and systolic function in children with chronic kidney disease-comparing echocardiography with cardiac magnetic resonance imaging.

Arnold R, Schwendinger D, Jung S, Pohl M, Jung B, Geiger J Pediatr Nephrol. 2015; 31(2):255-65.

PMID: 26342304 DOI: 10.1007/s00467-015-3198-z.

References

Engels G, Reynen K, Muller E, Wilke N, Bachmann K . [Quantitative evaluation of aortic valve insufficiency in magnetic resonance tomography]. Z Kardiol. 1993; 82(6):345-51. View

Bekeredjian R, Grayburn P . Valvular heart disease: aortic regurgitation. Circulation. 2005; 112(1):125-34. DOI: 10.1161/CIRCULATIONAHA.104.488825. View

Rominger M, Kluge A, Bachmann G . [Biventricular MR volumetric analysis and MR flow quantification in the ascending aorta and pulmonary trunk for quantification of valvular regurgitation]. Rofo. 2004; 176(3):342-9. DOI: 10.1055/s-2004-812751. View

Mathison M, Furuse A, Asano K . Doppler analysis of flow velocity profile at the aortic root. J Am Coll Cardiol. 1988; 12(4):947-54. DOI: 10.1016/0735-1097(88)90460-3. View

Reimold S, Maier S, Aggarwal K, Fleischmann K, Piwnica-Worms D, Kikinis R . Aortic flow velocity patterns in chronic aortic regurgitation: implications for Doppler echocardiography. J Am Soc Echocardiogr. 1996; 9(5):675-83. DOI: 10.1016/s0894-7317(96)90064-4. View

Goldberg S, ALLEN H . Quantitative assessment by Doppler echocardiography of pulmonary or aortic regurgitation. Am J Cardiol. 1985; 56(1):131-5. DOI: 10.1016/0002-9149(85)90581-8. View

Honda N, Machida K, Hashimoto M, Mamiya T, Takahashi T, Kamano T . Aortic regurgitation: quantitation with MR imaging velocity mapping. Radiology. 1993; 186(1):189-94. DOI: 10.1148/radiology.186.1.8416562. View

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

Tafreshi R, Shahmohammadi A, Davari P . Predictors of left ventricular performance after valve replacement in children and adolescents with chronic aortic regurgitation. Pediatr Cardiol. 2005; 26(4):331-7. DOI: 10.1007/s00246-005-8645-3. View

10.

Tornos P, Sambola A, Permanyer-Miralda G, Evangelista A, Gomez Z, Soler-Soler J . Long-term outcome of surgically treated aortic regurgitation: influence of guideline adherence toward early surgery. J Am Coll Cardiol. 2006; 47(5):1012-7. DOI: 10.1016/j.jacc.2005.10.049. View

11.

Yeung A, Plappert T, St John Sutton M . Calculation of aortic regurgitation orifice area by Doppler echocardiography: an application of the continuity equation. Br Heart J. 1992; 68(2):236-40. PMC: 1025024. DOI: 10.1136/hrt.68.8.236. View

12.

Bellenger N, Grothues F, Smith G, Pennell D . Quantification of right and left ventricular function by cardiovascular magnetic resonance. Herz. 2000; 25(4):392-9. DOI: 10.1007/s000590050031. View

13.

Dujardin K, Enriquez-Sarano M, Schaff H, Bailey K, Seward J, Tajik A . Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study. Circulation. 1999; 99(14):1851-7. DOI: 10.1161/01.cir.99.14.1851. View

14.

Segadal L . Velocity distribution model for normal blood flow in the human ascending aorta. Med Biol Eng Comput. 1991; 29(5):489-92. DOI: 10.1007/BF02442319. View

15.

Zoghbi W, Enriquez-Sarano M, Foster E, Grayburn P, Kraft C, Levine R . Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003; 16(7):777-802. DOI: 10.1016/S0894-7317(03)00335-3. View

16.

Didier D, Ratib O, Lerch R, Friedli B . Detection and quantification of valvular heart disease with dynamic cardiac MR imaging. Radiographics. 2000; 20(5):1279-99; discussion 1299-301. DOI: 10.1148/radiographics.20.5.g00jl111279. View

17.

Quinones M, Otto C, Stoddard M, Waggoner A, Zoghbi W . Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr. 2002; 15(2):167-84. DOI: 10.1067/mje.2002.120202. View

18.

Katz J, Milliken M, Stray-Gundersen J, Buja L, Parkey R, Mitchell J . Estimation of human myocardial mass with MR imaging. Radiology. 1988; 169(2):495-8. DOI: 10.1148/radiology.169.2.2971985. View

19.

Wyttenbach R, Bremerich J, Saeed M, Higgins C . Integrated MR imaging approach to valvular heart disease. Cardiol Clin. 1998; 16(2):277-94. DOI: 10.1016/s0733-8651(05)70013-8. View

20.

Sondergaard L, Lindvig K, Hildebrandt P, Thomsen C, Stahlberg F, Joen T . Quantification of aortic regurgitation by magnetic resonance velocity mapping. Am Heart J. 1993; 125(4):1081-90. DOI: 10.1016/0002-8703(93)90117-r. View