In:
Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 8 ( 2021-10-18)
Abstract:
Objectives: Transthoracic echocardiography (TTE) is the standard technique for assessing aortic stenosis (AS), with effective orifice area (EOA) recommended for grading severity. EOA is operator-dependent, influenced by a number of pitfalls and requires multiple measurements introducing independent and random sources of error. We tested the diagnostic accuracy and precision of aliased orifice area planimetry (AOA cmr ), a new, simple, non-invasive technique for grading of AS severity by low-VENC phase-contrast cardiovascular magnetic resonance (CMR) imaging. Methods: Twenty-two consecutive patients with mild, moderate, or severe AS and six age- and sex-matched healthy controls had TTE and CMR examinations on the same day. We performed analysis of agreement and correlation among (i) AOA cmr ; (ii) geometric orifice area (GOA cmr ) by direct CMR planimetry; (iii) EOA echo by TTE-continuity equation; and (iv) the “gold standard” multimodality EOA (EOA hybrid ) obtained by substituting CMR LVOT area into Doppler continuity equation. Results: There was excellent pairwise positive linear correlation among AOA cmr , EOA hybrid , GOA cmr , and EOA echo ( p & lt; 0.001); AOA cmr had the highest correlation with EOA hybrid ( R 2 = 0.985, p & lt; 0.001). There was good agreement between methods, with the lowest bias (0.019) for the comparison between AOA cmr and EOA hybrid . AOA cmr yielded excellent intra- and inter-rater reliability (intraclass correlation coefficient: 0.997 and 0.998, respectively). Conclusions: Aliased orifice area planimetry by 2D phase contrast imaging is a simple, reproducible, accurate “one-stop shop” CMR method for grading AS, potentially useful when echocardiographic severity assessment is inconclusive or discordant. Larger studies are warranted to confirm and validate these promising preliminary results.
Type of Medium:
Online Resource
ISSN:
2297-055X
DOI:
10.3389/fcvm.2021.752340
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2021
detail.hit.zdb_id:
2781496-8