Standard and emerging CMR methods for mitral regurgitation quantification
International Journal of Cardiology, vol. 331, pp. 316–321
Abstract
Background There are several methods to quantify mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR). The interoperability of these methods and their reproducibility remains undetermined. Objective To determine the agreement and reproducibility of different MR quantification methods by CMR across all aetiologies. Methods Thirty-five patients with MR were recruited (primary MR = 12, secondary MR = 10 and MVR = 13). Patients underwent CMR, including cines and four-dimensional flow (4D flow). Four methods were evaluated: MR Standard (left ventricular stroke volume - aortic forward flow by phase contrast), MR LVRV (left ventricular stroke volume - right ventricular stroke volume), MR Jet (direct jet quantification by 4D flow) and MR MVAV (mitral forward flow by 4D flow - aortic forward flow by 4D flow). For all cases and MR types, 520 MR volumes were recorded by these 4 methods for intra−/inter-observer tests. Results In primary MR, MR MVAV and MR LVRV were comparable to MR Standard ( P > 0.05). MR Jet resulted in significantly higher MR volumes when compared to MR Standard ( P < 0.05) In secondary MR and MVR cases, all methods were comparable. In intra-observer tests, MR MVAV demonstrated least bias with best limits of agreement (bias = −0.1 ml, −8 ml to 7.8 ml, P = 0.9) and best concordance correlation coefficient (CCC = 0.96, P < 0.01). In inter-observer tests, for primary MR and MVR, least bias and highest CCC were observed for MR MVAV . For secondary MR, bias was lowest for MR Jet (−0.1 ml, PNS). Conclusion CMR methods of MR quantification demonstrate agreement in secondary MR and MVR. In primary MR, this was not observed. Across all types of MR, MR MVAV quantification demonstrated the highest reproducibility and consistency.
Authors 20
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Sheffield Teaching Hospitals NHS Foundation Trust · University of Sheffield
Affiliation as printed
University of Sheffield, Sheffield, UK; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
University of Sheffield, Sheffield, UK
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Sheffield Teaching Hospitals NHS Foundation Trust
Affiliation as printed
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Sheffield Teaching Hospitals NHS Foundation Trust · University of Sheffield
Affiliation as printed
University of Sheffield, Sheffield, UK; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
University of Sheffield, Sheffield, UK
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Sheffield Teaching Hospitals NHS Foundation Trust · University of Sheffield
Affiliation as printed
University of Sheffield, Sheffield, UK; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
University of Sheffield, Sheffield, UK
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Rob J. van der Geest Aachen
Leiden University · Leiden University Medical Center
Affiliation as printed
Leiden University Medical Centre, Leiden, the Netherlands
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National Heart Centre Singapore
Affiliation as printed
National Heart Centre Singapore, Singapore
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National Heart Centre Singapore
Affiliation as printed
National Heart Centre Singapore, Singapore
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Affiliation as printed
University of Sheffield, Sheffield, UK
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Affiliation as printed
Bristol Heart Institute, Bristol, UK
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Affiliation as printed
Bristol Heart Institute, Bristol, UK
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Jeroen Joost Bax Aachen
Leiden University · Leiden University Medical Center
Affiliation as printed
Leiden University Medical Centre, Leiden, the Netherlands
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Affiliation as printed
University of Leeds, Leeds, UK
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Affiliation as printed
University of Oxford, Oxford, UK
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Pankaj Garg corresponding
Affiliation as printed
University of Sheffield, Sheffield, UK. Electronic address: Pankaj.Garg@nhs.net
University of Sheffield, Sheffield, UK
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