Valvular & structural heart disease
Optimizing Echocardiographic Evaluation of Chronic Mitral Regurgitation
- prospective study
- near-simultaneous cardiac magnetic resonance (CMR) and transthoracic echocardiography
+1 more
- near-simultaneous cardiac magnetic resonance (CMR) and transthoracic echocardiography
Authors' conclusion
Certain ASE criteria, especially when used in combination, are highly specific for diagnosing severe MR, even when <4 criteria are present. This study suggests that in many cases, the reliance on extensive quantification may be reduced, streamlining the diagnostic process and improving clinical workflow.
Study context
- Population
- Patients undergoing assessment of chronic mitral regurgitation (MR)patients who underwent near-simultaneous CMR and transthoracic echocardiography
- Participants
- 177 patients
- Exposure
- ASE native MR guidelines compared with quantitative cardiac magnetic resonance (CMR), considered the reference standard for MR assessment
Main finding
As reported in the abstract
Exact agreement
51%
Agreement within 1 grade
89%
Observational data: associations, not effects.
Further findings
CMR grade of patients meeting any ASE severe MR criterion
- Predominantly classified as having grades 3 to 4 MR by CMR
Specificity of ASE parameters for grade 4 MR by CMR
- Pulmonary vein systolic flow reversal
- 88%
- Enlarged left ventricular (LV) with normal systolic function
- 85%
- Proximal isovelocity surface area radius ≥1.0 cm
- 83%
- Vena contracta width ≥0.7 cm
- 80%
Specificity for severe MR of color Doppler combined with pulmonary vein systolic reversal or enlarged LV with normal function
- Specificity
- 91%-95%
Need for quantification by number of ASE criteria relied on
- 4 criteria
- 86%
- 3 criteria
- 73%
- 2 criteria
- 59%
Cohort characteristics
- Median age
- 61.7 years
- Men
- 55%
- Primary MR
- 73%
- Mitral valve prolapse
- 42%
- Flail leaflets
- 25%
Original publication
Summarised from the published abstract; every number is checked against it