Document Detail


Pulmonary regurgitation: determining severity by echocardiography and magnetic resonance imaging.
MedLine Citation:
PMID:  18557879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pulmonary regurgitation (PR) is common after repair of congenital heart disease involving the right ventricular outflow tract. Because PR results in chronic right ventricular volume overload and associated morbidity and mortality, accurate assessment of its severity is important. The aim of this study was to compare echocardiography with the gold standard of PR quantitation by magnetic resonance imaging (MRI) in a young population with repaired congenital heart disease.
DESIGN/METHODS: Patients with congenital heart disease who had undergone right ventricular outflow tract reconstruction and/or pulmonary valve replacement and had an MRI within 3 months of an echocardiogram formed the study group. Echocardiographic indices were compared with MRI-determined pulmonary regurgitant fraction (PRF) to determine the most accurate measurements to quantitate PR.
RESULTS: Of the 69 MRI/echocardiography pairs in 64 patients, 53 data sets were complete and used in the analysis. For the prediction of MRI PRF > or =20%, PR jet width/annulus ratio > or =0.5 demonstrated excellent sensitivity (94%), specificity (100%), positive predictive value (PPV 100%), and negative predictive value (NPV 82%). For the prediction of MRI PRF > or =40%, jet width/annulus ratio > or =0.7 and diastolic flow reversal in the branch pulmonary arteries showed useful sensitivity (92%), specificity (68%), PPV (76%), and NPV (88%).
CONCLUSION: Pulmonary regurgitation jet width/annulus ratio combined with diastolic flow reversal is the most valuable echocardiographic measure for assessing PR severity after right ventricular outflow tract reconstruction or pulmonary valve replacement; however, this surrogate measure does not replace the importance of MRI evaluation.
Authors:
Michael D Puchalski; Bojana Askovich; C Todd Sower; Richard V Williams; L Luann Minich; Lloyd Y Tani
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  3     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-06-18     Completed Date:  2008-08-26     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-75     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Utah and Primary Children's Medical Center, Salt Lake City, UT 84098, USA. Michael.puchalski@imail.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Echocardiography, Doppler, Color
Female
Humans
Infant
Magnetic Resonance Imaging
Male
Pulmonary Valve Insufficiency / diagnosis*
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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