| Valvular regurgitation: does cardiovascular magnetic resonance provide additional information compared to echocardiography? | |
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MedLine Citation:
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PMID: 19763073 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Surgical intervention for chronic aortic or mitral regurgitation in asymptomatic individuals is recommended on the basis of regurgitant severity and the hemodynamic consequences on the left ventricle (LV). Echocardiography is the standard tool in clinical practice for evaluation of adults with chronic regurgitation. Regurgitant volume (RV) and fraction (RF) can be determined as the difference between stroke volumes measured at two intracardiac sites: antegrade flow across the regurgitant valve compared to antegrade flow across a normal valve. Alternatively, these severity measures can be determined by imaging the proximal flow convergence. Regurgitant orifice area also can be determined. However, limitations do exist with echocardiography due to poor image quality, variability in measuring flow diameters and foreshortened views of the ventricle. Cardiac magnetic resonance (CMR) imaging is a promising modality which can also measure regurgitant severity and may provide additional information about LV size and function. Q-flow methods allow measurement of flow velocity and instantaneous volume flow rates in the aorta or pulmonary artery; this data can be integrated over the cardiac cycle to determine RV and RF. CMR also allows accurate measurement of left and right ventricular volumes; the difference in stroke volume between the two ventricles is regurgitant volume. The role of CMR in clinical management of adults with valve regurgitation merits further study. Currently, we find CMR helpful when regurgitant severity is indeterminant on echocardiography (particularly if LV dysfunction is present), when more accurate measures of LV function are needed and when aortic dilation is present. |
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Authors:
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P J Cawley; C M Otto |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Minerva cardioangiologica Volume: 57 ISSN: 0026-4725 ISO Abbreviation: Minerva Cardioangiol Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-09-18 Completed Date: 2010-02-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0400725 Medline TA: Minerva Cardioangiol Country: Italy |
Other Details:
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Languages: eng Pagination: 521-35 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA. cawley@u.washington.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aortic Valve Insufficiency / diagnosis*, ultrasonography* Cardiac Volume Chronic Disease Echocardiography / methods* Follow-Up Studies Humans Magnetic Resonance Imaging / methods* Mitral Valve Insufficiency / diagnosis*, ultrasonography* Severity of Illness Index Stroke Volume Time Factors Ventricular Dysfunction, Left / diagnosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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