Value of CMR in quantification of paravalvular aortic regurgitation after TAVI

Autor: Alexis Theron, Roch Giorgi, Alexis Jacquier, Marc Lambert, Erwan Salaun, Gilbert Habib, Thomas Cuisset, Dominique Grisoli, Jean-Louis Bonnet, Nicolas Jaussaud, Sandrine Hubert, Frederic Collart
Přispěvatelé: Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre de résonance magnétique biologique et médicale ( CRMBM ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Nutrition, obésité et risque thrombotique ( NORT ), Aix Marseille Université ( AMU ) -Institut National de la Recherche Agronomique ( INRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de chirurgie cardiaque, CUISSET, Thomas, Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
MESH : Prospective Studies
Severity of Illness Index
MESH : Aortic Valve Insufficiency
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Prospective Studies
Prospective cohort study
MESH: Multidetector Computed Tomography
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
General Medicine
MESH: Aortic Valve Insufficiency
MESH: Magnetic Resonance Imaging
Cine
[ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
MESH : Magnetic Resonance Imaging
Cine
MESH : Postoperative Care
MESH: Predictive Value of Tests
3. Good health
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
MESH: Reproducibility of Results
Echocardiography
Predictive value of tests
Cardiology
cardiovascular system
MESH : Severity of Illness Index
MESH : Multidetector Computed Tomography
MESH : Sensitivity and Specificity
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Transcatheter aortic
Aortic Valve Insufficiency
Magnetic Resonance Imaging
Cine
Regurgitation (circulation)
MESH : Transcatheter Aortic Valve Replacement
MESH: Postoperative Care
Sensitivity and Specificity
Transcatheter Aortic Valve Replacement
cardiovascular magnetic resonance
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Predictive Value of Tests
Internal medicine
medicine.artery
[ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology
MESH: Severity of Illness Index
Severity of illness
Ascending aorta
Multidetector Computed Tomography
medicine
Humans
Radiology
Nuclear Medicine and imaging
MESH : Predictive Value of Tests
transcatheter aortic valve implantation
Postoperative Care
MESH: Humans
business.industry
MESH : Echocardiography
MESH : Reproducibility of Results
MESH : Humans
Reproducibility of Results
aortic stenosis
aortic regurgitation
MESH: Prospective Studies
MESH: Sensitivity and Specificity
Regurgitant fraction
MESH: Echocardiography
MESH: Transcatheter Aortic Valve Replacement
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Edwards sapien
Zdroj: European Heart Journal-Cardiovascular Imaging
European Heart Journal-Cardiovascular Imaging, 2017, 17 (1), pp.41-50. ⟨10.1093/ehjci/jev177⟩
European Heart Journal-Cardiovascular Imaging, Oxford UP, 2017, pp.41-50
European Heart Journal-Cardiovascular Imaging, Oxford UP, 2017, 17 (1), pp.41-50. ⟨10.1093/ehjci/jev177⟩
European Heart Journal-Cardiovascular Imaging, Oxford UP, 2016, 17 (1), pp.41-50. ⟨10.1093/ehjci/jev177⟩
ISSN: 2047-2404
2047-2412
DOI: 10.1093/ehjci/jev177⟩
Popis: To assess the value of cardiac magnetic resonance (CMR) using phase-contrast velocity mapping for paravalvular aortic regurgitation (PAR) quantification.
All patients undergoing transcatheter aortic valve implantation (TAVI) in our centre between November 2012 and August 2013, without CMR-contraindication were included. PAR severity was assessed 5 days after TAVI using: transthoracic echocardiography (TTE) and CMR [regurgitant volume (RV), regurgitant fraction (RF)]. Aortic regurgitation (AR) index was obtained during TAVI. Thirty of 51 patients who underwent TAVI were included (COREVALVE, n = 10; or EDWARDS SAPIEN XT, n = 20). At TTE, PAR was mild in 22, moderate in 3, and severe in 5 patients. Reliable phase-contrast images were acquired at the sino-tubular junction for SAPIEN and at the tubular portion of the ascending aorta for COREVALVE. The reproducibility of CMR was high (coefficient of correlation = 0.99 for intra- and inter-operator variability). At CMR, RV, and RF were significantly (P < 0.0005) correlated with AR severity at TTE, with mean RF values at 9.2 ± 7.6% in mild, 20.3 ± 4.2% in moderate, and 46.8 ± 10.8% in severe PAR. A cut-off value of RF < 14% at CMR accurately discriminated mild from moderate/severe (sensitivity: 100%, specificity: 82%). The mean AR index was 29.4 ± 6 for mild and 13.8 ± 5 for moderate/severe PAR. Three patients had a RF > 14% and a low AR index
CMR is a reproducible, accurate, and reliable method to assess PAR severity. CMR may allow correcting an underestimation at TTE when AR index is doubtful.
Databáze: OpenAIRE
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