Valvular & structural heart diseaseDiagnostic or prognostic study
Echocardiographic Evaluation of Chronic Aortic Regurgitation
- Diagnostic accuracy study
Authors' conclusion
The ASE guidelines display very good performance in identifying significant AR. A simplified approach using vena contracta width and LV volumes can be used to reliably identify significant AR.
Study context
- Population
- Patients with chronic aortic regurgitation (AR) undergoing echocardiography and cardiac magnetic resonance (CMR) <4 hours apart (median age 52 years, 58% bicuspid aortic valve)
- Participants
- 81 patients
- Comparison
- ASE echocardiographic AR grading and echo parameters vs CMR
- Outcome
- Accuracy of ASE AR guidelines for detection of severe AR against CMR
Performance
As reported in the abstract
Detection of severe AR by CMR
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| ASE grading | 0.9 | 82.4% | 96.9% |
Further findings
| Outcome | Values |
|---|---|
| Identifying ≥moderate to severe AR by CMR, simplified approach | VC width + LVEDVi PPV 95.5% · NPV 87.5% · AUC 0.89 |
Echo parameters vs CMR
- Highest accuracy: vena contracta width, jet width, left ventricular (LV) end-diastolic volume index (AUC)
- 0.86-0.89
- Pressure half-time had the lowest accuracy
Feasibility of regurgitant volume (RegV) quantitation
- Either echo volumetric method
- >88%
- Proximal isovelocity surface area
- 37%
AR severity by echo
- Mild
- 35 (43%)
- Moderate
- 18 (22%)
- Moderate to severe
- 12 (15%)
- Severe
- 16 (20%)
Original publication
Echocardiographic Evaluation of Chronic Aortic Regurgitation. JACC Cardiovasc Imaging. Published 13 November 2024. doi:10.1016/j.jcmg.2024.08.013
Summarised from the published abstract; every number is checked against it