Quantification of mitral regurgitation in patients with hypertrophic cardiomyopathy using aortic and pulmonary flow data: impacts of left ventricular outflow tract obstruction and different left ventricular segmentation methods

Autor: Mateusz Śpiewak, Mariusz Kłopotowski, Monika Gawor, Agata Kubik, Ewa Kowalik, Barbara Miłosz-Wieczorek, Maciej Dąbrowski, Konrad Werys, Łukasz Mazurkiewicz, Katarzyna Kożuch, Magdalena Polańska-Skrzypczyk, Joanna Petryka-Mazurkiewicz, Anna Klisiewicz, Zofia T. Bilińska, Jacek Grzybowski, Adam Witkowski, Magdalena Marczak
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Journal of Cardiovascular Magnetic Resonance, Vol 19, Iss 1, Pp 1-17 (2017)
Druh dokumentu: article
ISSN: 1532-429X
DOI: 10.1186/s12968-017-0417-8
Popis: Abstract Background Cardiovascular magnetic resonance (CMR) imaging in patients with hypertrophic cardiomyopathy (HCM) enables the assessment of not only left ventricular (LV) hypertrophy and scarring but also the severity of mitral regurgitation. CMR assessment of mitral regurgitation is primarily based on the difference between LV stroke volume (LVSV) and aortic forward flow (Ao) measured using the phase-contrast (PC) technique. However, LV outflow tract (LVOT) obstruction causing turbulent, non-laminar flow in the ascending aorta may impact the accuracy of aortic flow quantification, leading to false conclusions regarding mitral regurgitation severity. Thus, we decided to quantify mitral regurgitation in patients with HCM using Ao or, alternatively, main pulmonary artery forward flow (MPA) for mitral regurgitation volume (MRvol) calculations. Methods The analysis included 143 prospectively recruited subjects with HCM and 15 controls. MRvol was calculated as the difference between LVSV computed with either the inclusion (LVSVincl) or exclusion (LVSVexcl) of papillary muscles and trabeculations from the blood pool and either Ao (MRvolAoi or MRvolAoe) or MPA (MRvolMPAi or MRvolMPAe). The presence or absence of LVOT obstruction was determined based on Doppler echocardiography findings. Results MRvolAoi was higher than MRvolMPAi in HCM patients with LVOT obstruction [47.0 ml, interquartile range (IQR) = 31.5–60.0 vs. 35.5 ml, IQR = 26.0–51.0; p
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