Cardiac magnetic resonance assessment of left ventricular dilatation in chronic severe left-sided regurgitations: comparison with standard echocardiography

Autor: Alexis Theron, Jennifer Cautela, Franck Thuny, Maxime Guye, Axel Bartoli, Thibaut Capron, H. Lepidi, Johan Pinto, Jean-François Avierinos, Ugo Scemama, Frédéric Collart, Alexis Jacquier, Charlène Miola, Monique Bernard, A. Porto
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), Hôpital de la Timone [CHU - APHM] (TIMONE), Département d'hématologie biologique[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Magnetic Resonance Spectroscopy
Adolescent
Left
Regurgitation (circulation)
Severity of Illness Index
Asymptomatic
Left sided
030218 nuclear medicine & medical imaging
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
Lv dysfunction
medicine
Humans
Cardiac magnetic resonance imaging (CMR)
Left ventricular dilatation
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Ventricular dysfunction
Aged
Mitral valve insufficiency
Aged
80 and over
Mitral regurgitation
Radiological and Ultrasound Technology
business.industry
Area under the curve
General Medicine
Middle Aged
Dilatation
3. Good health
Aortic valve insufficiency
Echocardiography
030220 oncology & carcinogenesis
cardiovascular system
Cardiology
Female
medicine.symptom
Cardiac magnetic resonance
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: Diagnostic and Interventional Imaging
Diagnostic and Interventional Imaging, 2020, 101 (10), pp.657-665. ⟨10.1016/j.diii.2020.04.014⟩
Diagnostic and Interventional Imaging, Elsevier, 2020, 101 (10), pp.657-665. ⟨10.1016/j.diii.2020.04.014⟩
ISSN: 2211-5684
DOI: 10.1016/j.diii.2020.04.014
Popis: International audience; Purpose: The purpose of this study was to investigate the potential additional value of cardiac magnetic resonance (CMR) in the assessment of left ventricular (LV) dilatation and dysfunction by comparison to standard echocardiography in patients with chronic left-sided valvular regurgitation.Materials and methods: We prospectively enrolled patients with chronic severe mitral regurgitation (MR) or aortic regurgitation (AR). They underwent standard echocardiography and CMR using aortic flow and LV-function sequences. LV dilatation or dysfunction was assessed with each technique, based on thresholds used for surgery indication. Reference regurgitation severity was defined following previously reported CMR-based regurgitant volume thresholds.Results: A total of 71 patients with chronic severe MR (n= 44) or severe AR (n= 27) were prospectively included. There were 60 men and 11 women with a mean age of 61 + 14 (SD) years (range: 18-83 years). CMR-based regurgitation severity was significantly greater in the LV dysfunction group when assessed with CMR (MR, P = 0.011; AR, P= 0.006) whereas it was not different when LV dysfunction was assessed using standard echocardiography. Among standard echocardiography and CMR volumetric indices, CMR-derived end-diastolic volume showed the best ability to predict regurgitation severity (area under the curve [AUC] = 0.78 for MR; AUC = 0.91 for AR). Diagnostic thresholds identified on receiver operating characteristics-curve analysis were lower than those of current European recommendations and closer to North-American guidelines.Conclusion: CMR assessment of LV end-diastolic volume in chronic severe left-sided regurgitations is more reliably associated with CMR-based regurgitant volume by comparison with standard echocardiography diameter. CMR may provide useful evaluation before surgery decision for severe asymptomatic regurgitations. (C) 2020 Societe francaise de radiologie.
Databáze: OpenAIRE
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