Abstract
Objectives: This study sought to compare a new quantitative angiographic technique to cardiac magnetic resonance-derived regurgitation fraction (CMR-RF) for the quantification of prosthetic valve regurgitation (PVR) after transcatheter aortic valve replacement (TAVR). Background: PVR after TAVR is challenging to quantify, especially during the procedure. Methods: Post-replacement aortograms in 135 TAVR recipients were analyzed offline by videodensitometry to measure the ratio of the time-resolved contrast density in the left ventricular outflow tract to that in the aortic root (videodensitometric aortic regurgitation [VD-AR]). CMR was performed within an interval of ≤30 days (11 ± 6 days) after the procedure. Results: The average CMR-RF was 6.7 ± 7.0% whereas the average VD-AR was 7.0 ± 7.0%. The correlation between VD-AR and CMR-RF was substantial (r = 0.78, p < 0.001). On receiver-operating characteristic curves, a VD-AR ≥10% corresponded to >mild PVR as defined by CMR-RF (area under the curve: 0.94; p < 0.001; sensitivity 100%, specificity 83%), whereas a VD-AR ≥25% corresponded to moderate-to-severe PVR (area under the curve: 0.99; p = 0.004; sensitivity 100%, specificity 98%). Intraobserver reproducibility was excellent for both techniques (for CMR-RF, intraclass correlation coefficient: 0.91, p < 0.001; for VD-AR intraclass correlation coefficient: 0.93, p < 0.001). The difference on rerating was –0.04 ± 7.9% for CMR-RF and –0.40 ± 6.8% for VD-AR. Conclusions: The angiographic VD-AR provides a surrogate assessment of PVR severity after TAVR that correlates well with the CMR-RF.
| Original language | English |
|---|---|
| Pages (from-to) | 287-297 |
| Number of pages | 11 |
| Journal | JACC: Cardiovascular Interventions |
| Volume | 11 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 12 Feb 2018 |
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Keywords
- angiography
- aortic valve
- magnetic resonance
- regurgitation
- stenosis
- transcatheter
Cite this
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A novel angiographic quantification of aortic regurgitation after TAVR provides an accurate estimation of regurgitation fraction derived from cardiac magnetic resonance imaging. / Abdel-Wahab, M.; Abdelghani, M.; Miyazaki, Y.; Holy, E.W.; Merten, C.; Zachow, D.; Tonino, W.A.L.; Rutten, M.C.M.; van de Vosse, F.N.; Morel, M.A.; Onuma, Y.; Serruys, P.W.; Richardt, G.; Soliman, O.I.
In: JACC: Cardiovascular Interventions, Vol. 11, No. 3, 12.02.2018, p. 287-297.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - A novel angiographic quantification of aortic regurgitation after TAVR provides an accurate estimation of regurgitation fraction derived from cardiac magnetic resonance imaging
AU - Abdel-Wahab, M.
AU - Abdelghani, M.
AU - Miyazaki, Y.
AU - Holy, E.W.
AU - Merten, C.
AU - Zachow, D.
AU - Tonino, W.A.L.
AU - Rutten, M.C.M.
AU - van de Vosse, F.N.
AU - Morel, M.A.
AU - Onuma, Y.
AU - Serruys, P.W.
AU - Richardt, G.
AU - Soliman, O.I.
PY - 2018/2/12
Y1 - 2018/2/12
N2 - Objectives: This study sought to compare a new quantitative angiographic technique to cardiac magnetic resonance-derived regurgitation fraction (CMR-RF) for the quantification of prosthetic valve regurgitation (PVR) after transcatheter aortic valve replacement (TAVR). Background: PVR after TAVR is challenging to quantify, especially during the procedure. Methods: Post-replacement aortograms in 135 TAVR recipients were analyzed offline by videodensitometry to measure the ratio of the time-resolved contrast density in the left ventricular outflow tract to that in the aortic root (videodensitometric aortic regurgitation [VD-AR]). CMR was performed within an interval of ≤30 days (11 ± 6 days) after the procedure. Results: The average CMR-RF was 6.7 ± 7.0% whereas the average VD-AR was 7.0 ± 7.0%. The correlation between VD-AR and CMR-RF was substantial (r = 0.78, p < 0.001). On receiver-operating characteristic curves, a VD-AR ≥10% corresponded to >mild PVR as defined by CMR-RF (area under the curve: 0.94; p < 0.001; sensitivity 100%, specificity 83%), whereas a VD-AR ≥25% corresponded to moderate-to-severe PVR (area under the curve: 0.99; p = 0.004; sensitivity 100%, specificity 98%). Intraobserver reproducibility was excellent for both techniques (for CMR-RF, intraclass correlation coefficient: 0.91, p < 0.001; for VD-AR intraclass correlation coefficient: 0.93, p < 0.001). The difference on rerating was –0.04 ± 7.9% for CMR-RF and –0.40 ± 6.8% for VD-AR. Conclusions: The angiographic VD-AR provides a surrogate assessment of PVR severity after TAVR that correlates well with the CMR-RF.
AB - Objectives: This study sought to compare a new quantitative angiographic technique to cardiac magnetic resonance-derived regurgitation fraction (CMR-RF) for the quantification of prosthetic valve regurgitation (PVR) after transcatheter aortic valve replacement (TAVR). Background: PVR after TAVR is challenging to quantify, especially during the procedure. Methods: Post-replacement aortograms in 135 TAVR recipients were analyzed offline by videodensitometry to measure the ratio of the time-resolved contrast density in the left ventricular outflow tract to that in the aortic root (videodensitometric aortic regurgitation [VD-AR]). CMR was performed within an interval of ≤30 days (11 ± 6 days) after the procedure. Results: The average CMR-RF was 6.7 ± 7.0% whereas the average VD-AR was 7.0 ± 7.0%. The correlation between VD-AR and CMR-RF was substantial (r = 0.78, p < 0.001). On receiver-operating characteristic curves, a VD-AR ≥10% corresponded to >mild PVR as defined by CMR-RF (area under the curve: 0.94; p < 0.001; sensitivity 100%, specificity 83%), whereas a VD-AR ≥25% corresponded to moderate-to-severe PVR (area under the curve: 0.99; p = 0.004; sensitivity 100%, specificity 98%). Intraobserver reproducibility was excellent for both techniques (for CMR-RF, intraclass correlation coefficient: 0.91, p < 0.001; for VD-AR intraclass correlation coefficient: 0.93, p < 0.001). The difference on rerating was –0.04 ± 7.9% for CMR-RF and –0.40 ± 6.8% for VD-AR. Conclusions: The angiographic VD-AR provides a surrogate assessment of PVR severity after TAVR that correlates well with the CMR-RF.
KW - angiography
KW - aortic valve
KW - magnetic resonance
KW - regurgitation
KW - stenosis
KW - transcatheter
UR - http://www.scopus.com/inward/record.url?scp=85041130795&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2017.08.045
DO - 10.1016/j.jcin.2017.08.045
M3 - Article
C2 - 29361447
AN - SCOPUS:85041130795
VL - 11
SP - 287
EP - 297
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
SN - 1936-8798
IS - 3
ER -