Echocardiography vs. CMR in the Quantification of Chronic Mitral Regurgitation: A Happy Marriage or Stormy Divorce?
Articolo
Data di Pubblicazione:
2023
Citazione:
Echocardiography vs. CMR in the Quantification of Chronic
Mitral Regurgitation: A Happy Marriage or Stormy Divorce? / B. Francesca, F. Laura, M. Manuela, T. Gloria, Sarah Ghulam Ali, M. Valentina, A. Baggiano, M. Saima, P. Mauro, P. Giuseppe, G. Pontone. - In: JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE. - ISSN 2308-3425. - 10:4(2023), pp. 150.1-150.12. [10.3390/jcdd10040150]
Abstract:
Quantification of chronic mitral regurgitation (MR) is essential to guide patients’ clinical
management and define the need and appropriate timing for mitral valve surgery. Echocardiography
represents the first-line imaging modality to assess MR and requires an integrative approach based
on qualitative, semiquantitative, and quantitative parameters. Of note, quantitative parameters,
such as the echocardiographic effective regurgitant orifice area, regurgitant volume (RegV), and
regurgitant fraction (RegF), are considered the most reliable indicators of MR severity. In contrast,
cardiac magnetic resonance (CMR) has demonstrated high accuracy and good reproducibility in
quantifying MR, especially in cases with secondary MR; nonholosystolic, eccentric, and multiple
jets; or noncircular regurgitant orifices, where quantification with echocardiography is an issue.
No gold standard for MR quantification by noninvasive cardiac imaging has been defined so far.
Only a moderate agreement has been shown between echocardiography, either with transthoracic or
transesophageal approaches, and CMR in MR quantification, as supported by numerous comparative
studies. A higher agreement is evidenced when echocardiographic 3D techniques are used. CMR is
superior to echocardiography in the calculation of the RegV, RegF, and ventricular volumes and can
provide myocardial tissue characterization. However, echocardiography remains fundamental in the
pre-operative anatomical evaluation of the mitral valve and of the subvalvular apparatus. The aim of
this review is to explore the accuracy of MR quantification provided by echocardiography and CMR
in a head-to-head comparison between the two techniques, with insight into the technical aspects of
each imaging modality.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
mitral regurgitation; mitral valve prolapse; echocardiography; cardiovascular magnetic resonance; multimodality imaging; mitral valve surgery
Elenco autori:
B. Francesca, F. Laura, M. Manuela, T. Gloria, Sarah Ghulam Ali, M. Valentina, A. Baggiano, M. Saima, P. Mauro, P. Giuseppe, G. Pontone
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