Seth Uretsky1, Linda Gillam1, Roberto Lang2, Farooq A Chaudhry3, Edgar Argulian4, Azhar Supariwala4, Srinivasa Gurram4, Kavya Jain4, Marjorie Subero4, James J Jang5, Randy Cohen4, Steven D Wolff6. 1. Department of Cardiovascular Medicine, Morristown Medical Center, Morristown, New Jersey. 2. Department of Medicine, Section of Cardiology, University of Chicago, Chicago, Illinois. 3. Department of Cardiovascular Medicine, Icahn School of Medicine at Mount Sinai School of Medicine, New York, New York. 4. Division of Cardiology, Mt. Sinai St. Luke's and Roosevelt Hospitals, Icahn School of Medicine at Mount Sinai School of Medicine, New York, New York. 5. San Jose Medical Center, Kaiser Permanente, San Jose, California. 6. Carnegie Hill Radiology, New York, New York. Electronic address: sdwolff@mrict.com.
Abstract
BACKGROUND: The decision to undergo mitral valve surgery is often made on the basis of echocardiographic criteria and clinical assessment. Recent changes in treatment guidelines recommending surgery in asymptomatic patients make the accurate assessment of mitral regurgitation (MR) severity even more important. OBJECTIVES: The purpose of this study was to compare echocardiography and magnetic resonance imaging (MRI) in the assessment of MR severity using the degree of left ventricular (LV) remodeling after surgery as the reference standard. METHODS: In this prospective multicenter trial, MR severity was assessed in 103 patients using both echocardiography and MRI. Thirty-eight patients subsequently had isolated mitral valve surgery, and 26 of these had an additional MRI performed 5 to 7 months after surgery. The pre-surgical estimate of regurgitant severity was correlated with the postoperative decrease in LV end-diastolic volume. RESULTS: Agreement between MRI and echocardiographic estimates of MR severity was modest in the overall cohort (r = 0.6; p < 0.0001), and there was a poorer correlation in the subset of patients sent for surgery (r = 0.4; p = 0.01). There was a strong correlation between post-surgical LV remodeling and MR severity as assessed by MRI (r = 0.85; p < 0.0001), and no correlation between post-surgical LV remodeling and MR severity as assessed by echocardiography (r = 0.32; p = 0.1). CONCLUSIONS: The data suggest that MRI is more accurate than echocardiography in assessing the severity of MR. MRI should be considered in those patients when MR severity as assessed by echocardiography is influencing important clinical decisions, such as the decision to undergo MR surgery.
BACKGROUND: The decision to undergo mitral valve surgery is often made on the basis of echocardiographic criteria and clinical assessment. Recent changes in treatment guidelines recommending surgery in asymptomatic patients make the accurate assessment of mitral regurgitation (MR) severity even more important. OBJECTIVES: The purpose of this study was to compare echocardiography and magnetic resonance imaging (MRI) in the assessment of MR severity using the degree of left ventricular (LV) remodeling after surgery as the reference standard. METHODS: In this prospective multicenter trial, MR severity was assessed in 103 patients using both echocardiography and MRI. Thirty-eight patients subsequently had isolated mitral valve surgery, and 26 of these had an additional MRI performed 5 to 7 months after surgery. The pre-surgical estimate of regurgitant severity was correlated with the postoperative decrease in LV end-diastolic volume. RESULTS: Agreement between MRI and echocardiographic estimates of MR severity was modest in the overall cohort (r = 0.6; p < 0.0001), and there was a poorer correlation in the subset of patients sent for surgery (r = 0.4; p = 0.01). There was a strong correlation between post-surgical LV remodeling and MR severity as assessed by MRI (r = 0.85; p < 0.0001), and no correlation between post-surgical LV remodeling and MR severity as assessed by echocardiography (r = 0.32; p = 0.1). CONCLUSIONS: The data suggest that MRI is more accurate than echocardiography in assessing the severity of MR. MRI should be considered in those patients when MR severity as assessed by echocardiography is influencing important clinical decisions, such as the decision to undergo MR surgery.
Authors: Paul A Grayburn; Lilin She; Brad J Roberts; Krzysztof S Golba; Krzysztof Mokrzycki; Jaroslaw Drozdz; Alexander Cherniavsky; Roman Przybylski; Krzysztof Wrobel; Federico M Asch; Thomas A Holly; Haissam Haddad; Michael Yii; Gerald Maurer; Irving Kron; Hartzell Schaff; Eric J Velazquez; Jae K Oh Journal: Am J Cardiol Date: 2015-06-25 Impact factor: 2.778
Authors: Ayman K M Hassan; Magdy I Algowhary; Aya Y T Kishk; Amr Ahmed Aly Youssef; Nady A Razik Journal: Int J Cardiovasc Imaging Date: 2020-02-03 Impact factor: 2.357