Aortic regurgitation and left ventricle remodeling on cardiac magnetic resonance and transthoracic echocardiography.

Abstract

Transthoracic echocardiography (TTE) is the first imaging modality used to assess aortic regurgitation (AR). However, it is not possible to provide precise quantification in all patients. Our aim was to compare TTE and cardiovascular magnetic resonance (CMR) measurements in grading AR and left ventricle (LV) remodeling. A total of 51 consecutive patients with AR in TTE (New York Heart Association I/II, 55%/38%) were enrolled into the study and 49 individuals (age, 57.1 [14]; 61% males) underwent a non-contrast CMR (2 patients excluded) obtained on 1.5 T system (GE Optima MR450w). The comprehensive quantitative grading with AR volume (AR vol) and regurgitant fraction (RF) were measurable in TTE in 24 cases and showed an association with CMR parameters (AR vol: r = 0.75; P <0.001 and RF: r = 0.55; P <0.01). CMR revealed larger LV end-diastolic volumes (EDV) (185.5 [61] vs 158.4 [61] ml; P = 0.03) and a trend towards higher left ventricular ejection fraction (59% [8] vs 56% [8]; P = 0.08). The association of AR vol and LV EDV was stronger in CMR (r = 0.85; P <0.0001) compared to TTE (r = 0.6; P = 0.001). The inter-modality agreement (TTE-CMR) in AR grading was low (κ = 0.15), with highly concordant grading in mild AR (91%). CMR provides a comprehensive assessment of AR severity and LV remodeling with a weak or a moderate agreement with TTE.