Limitations of qualitative angiographic grading in aortic or mitral regurgitation

Croft, Charles H.; Lipscomb, Kirk; Mathis, Kenneth; Firth, Brian G.; Nicod, Pascal; Tilton, Gregory; Winniford, Michael D.; Hillis, L.David

doi:10.1016/0002-9149(84)90585-x

Cited by 247 publications

(58 citation statements)

References 25 publications

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“…Unfortu nately, these approaches usually lack reliability. Angio graphy (1) has been the standard clinical technique, but it is invasive, only semiquantitative, and involves radia tion exposure. A variety of echocardiographic and MRI techniques (2)(3)(4)(5)(6)(7)(8)(9)(10) have been studied recently to assess mitral regurgitation.…”

mentioning

confidence: 99%

Quantification of mitral regurgitation with MR phase‐velocity mapping using a control volume method

Chatzimavroudis

Oshinski

Pettigrew

et al. 1998

Magnetic Resonance Imaging

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Reliable diagnosis and quantification of mitral regurgitation are important for patient management and for optimizing the time for surgery. Previous methods have often provided suboptimal results. The aim of this in vitro study was to evaluate MR phase‐velocity mapping in quantifying the mitral regurgitant volume (MRV) using a control volume (CV) method. A number of contiguous slices were acquired with all three velocity components measured. A CV was then selected, encompassing the regurgitant orifice. Mass conservation dictates that the net inflow into the CV should be equal to the regurgitant flow. Results showed that a CV, the boundary voxels of which excluded the region of flow acceleration and aliasing at the orifice, provided accurate measurements of the regurgitant flow. A smaller CV provided erroneous results because of flow acceleration and velocity aliasing close to the orifice. A large CV generally provided inaccurate results because of reduced velocity sensitivity far from the orifice. Aortic outflow, orifice shape, and valve geometry did not affect the accuracy of the CV measurements. The CV method is a promising approach to the problem of quantification of the MRV.

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mentioning

confidence: 99%

Quantification of mitral regurgitation with MR phase‐velocity mapping using a control volume method

Chatzimavroudis

Oshinski

Pettigrew

et al. 1998

Magnetic Resonance Imaging

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“…Unfortunately, these ap proaches usually lack reliability. Angiography [22] has been traditionally used to diagnose the disease, but it is invasive, only semi-quantitative, and in volves radiation exposure. A variety of echocar diographic and MR techniques [23][24][25][26][27][28][29] have also been evaluated to assess regurgitation focusing on the jet side of the regurgitant valve.…”

Section: Heart Valve Regurgitationmentioning

confidence: 99%

Blood flow measurements with magnetic resonance phase velocity mapping

Chatzimavroudis

2005

Measurement

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“…4,9,10,16 Methodological limitations of the flow convergence method as well as of angiography, the reference method in our study, probably contributed to these results. 17,18 The flow convergence method allows calculation of regurgitant volumes in mitral regurgitation. 3,5 However, previously published studies using TTE or TEE demonstrated an overestimation of the regurgitant volume by the proximal flow convergence method.…”

Section: Comparison Between Echocardiography and Cardiac Catheterizationmentioning

confidence: 99%

Quantification of Mitral Regurgitation by the Proximal Flow Convergence Method—Comparison of Transthoracic and Transesophageal Echocardiography

Großmann

Wöhrle

Kochs

et al. 2002

Clinical Cardiology

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SummaryBackground: No data exist to indicate whether transthoracic (TTE) and transesophageal echocardiography (TEE) are of comparable value for the detection and quantification of mitral regurgitation using the proximal flow convergence method.Hypothesis: The study was performed to compare the value of TTE and TEE for the detection and quantification of mitral regurgitation using this method.Methods: The study included 57 patients with and 11 patients without mitral regurgitation. In all patients, the proximal flow convergence region was imaged by transthoracic and transesophageal color Doppler echocardiography, and proximal isovelocity surface area radii were determined. In 19 patients, monoplane TEE and in 49 patients multiplane TEE was performed. Thirty-one patients with mitral regurgitation underwent cardiac catheterization.Results: Both methods had a comparable sensitivity for the detection of mitral regurgitation. Proximal isovelocity surface area radii derived from TTE and TEE agreed moderately (mean difference Ϫ0.5 ± 1.3 mm). TTE and TEE correlated significantly with the angiographic grade (rank correlation coefficients 0.83 and 0.81), and both differentiated mild to moderate from severe mitral regurgitation with an accuracy of 90%. Regurgitant volumes derived from both echocardiographic techniques and cardiac catheterization correlated moderately (correlation coefficients between 0.67 and 0.81).

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Limitations of qualitative angiographic grading in aortic or mitral regurgitation

Cited by 247 publications

References 25 publications

Quantification of mitral regurgitation with MR phase‐velocity mapping using a control volume method

Quantification of mitral regurgitation with MR phase‐velocity mapping using a control volume method

Blood flow measurements with magnetic resonance phase velocity mapping

Quantification of Mitral Regurgitation by the Proximal Flow Convergence Method—Comparison of Transthoracic and Transesophageal Echocardiography

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