Assessment of paravalvular regurgitation after transcatheter aortic valve replacement using 2D multi-velocity encoding and 4D flow cardiac magnetic resonance.

Autor:	Rooijakkers MJP; Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands., El Messaoudi S; Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands., Stens NA; Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.; Department of Medical BioSciences, Radboud University Medical Centre, Nijmegen, The Netherlands., van Wely MH; Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands., Habets J; Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.; Department of Radiology and Nuclear Medicine, Haaglanden Medical Centre, The Hague, The Netherlands., Brink M; Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands., Rodwell L; Department of Health Sciences, Section Biostatistics, Radboud Institute for Health Sciences, Nijmegen, The Netherlands., Giese D; Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany.; Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany., van der Geest RJ; Department of Medical Imaging, Leiden University Medical Centre, Leiden, The Netherlands., van Royen N; Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands., Nijveldt R; Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2024 Jun 28; Vol. 25 (7), pp. 929-936.
DOI:	10.1093/ehjci/jeae035
Abstrakt:	Aims: To compare the novel 2D multi-velocity encoding (venc) and 4D flow acquisitions with the standard 2D flow acquisition for the assessment of paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR) using cardiac magnetic resonance (CMR)-derived regurgitant fraction (RF). Methods and Results: In this prospective study, patients underwent CMR 1 month after TAVR for the assessment of PVR, for which 2D multi-venc and 4D flow were used, in addition to standard 2D flow. Scatterplots and Bland-Altman plots were used to assess correlation and visualize agreement between techniques. Reproducibility of measurements was assessed with intraclass correlation coefficients. The study included 21 patients (mean age ± SD 80 ± 5 years, 9 men). The mean RF was 11.7 ± 10.0% when standard 2D flow was used, 10.6 ± 7.0% when 2D multi-venc flow was used, and 9.6 ± 7.3% when 4D flow was used. There was a very strong correlation between the RFs assessed with 2D multi-venc and standard 2D flow (r = 0.88, P < 0.001), and a strong correlation between the RFs assessed with 4D flow and standard 2D flow (r = 0.74, P < 0.001). Bland-Altman plots revealed no substantial bias between the RFs (2D multi-venc: 1.3%; 4D flow: 0.3%). Intra-observer and inter-observer reproducibility for 2D multi-venc flow were 0.98 and 0.97, respectively, and 0.92 and 0.90 for 4D flow, respectively. Conclusion: Two-dimensional multi-venc and 4D flow produce an accurate quantification of PVR after TAVR. The fast acquisition of the 2D multi-venc sequence and the free-breathing acquisition with retrospective plane selection of the 4D flow sequence provide useful advantages in clinical practice, especially in the frail TAVR population. Competing Interests: Conflict of interest: M.H.v.W. has been a proctor and consultant for Abbott Vascular. D.G. has been an employee of Siemens Healthcare GmbH. N.v.R. has received research funding from Abbott, Philips, Medtronic, and Biotronik; has served as a consultant for RainMed, Castor, and Medtronic; and has received speaker fees from Abbott and Bayer. R.N. has received research funding from Philips Volcano and Biotronik; has served as a consultant for BMS and Sanofi; and has received speaker fees from BMS, Canon, Pfizer, and Sanofi. The other authors do not have potential conflicts of interest or disclosures to report. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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