Quantitative aortography vs cardiac MRI in the assessment of aortic regurgitation

Abstract

Introduction: Visual assessment of aortic regurgitation (AR) on contrast aortography via Sellers’ technique is problematic in being a subjective measurement with significant interobserver and intraobserver variability affecting its validity, reproducibility and accuracy. Objectives: To evaluate a new software for objective quantificationof aortic regurgitationbyusing timedensity changes during contrast aortography (CAAS qRA, Pie Medical Imaging,Maastricht, Netherlands) in comparison to gold standard assessment with cardiac MRI. Methods:Aortogramswereprospectively acquiredaccording to a standardised protocol to ensure image quality criteria for inclusion were met: entire left ventricle and aortic root in view, descending aorta not over-projected, breath hold, no table motion, and adequate contrast opacification of the aortic root. AR was quantified with the qRA software which compared contrast density changes in the aortic root and left ventricle to calculate the relative area under the curve (RAUC) andqRA index. Regurgitation fromvelocity encoded MRI was quantified as regurgitant fraction and volume measured at the level of the LV outflow tract and ascending aorta. Correlation between quantitative assessment of aortic regurgitation with qRA software and cardiac MRI was done with a Pearson’s coefficient. Results: * p < 0.05