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Quantification of functional mitral valve regurgitation in patients with congestive heart failure: comparison of
Alexander Lembcke1, Adrian C Borges, Pascal M Dohmen
1Department of Radiology, Charité Medical School, University Medicine Berlin, Berlin, Germany. alexander.lembcke@gmx.de
Insights
Electron-beam computed tomography (CT) quantifies mitral regurgitation volume and fraction with accuracy similar to cardiac catheterization. Both methods correlate well with echocardiography, offering reliable assessments for heart failure patients.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Mitral regurgitation (MR) is a significant complication in heart failure.
- Accurate quantification of MR is crucial for patient management.
- Comparing novel imaging techniques with established methods is essential.
Purpose of the Study:
- To determine the agreement between electron-beam CT and cardiac catheterization for quantifying mitral regurgitation.
- To evaluate the association of both modalities with echocardiographic assessment.
Main Methods:
- Fifty patients with heart failure underwent both electron-beam CT and cardiac catheterization.
- Mitral regurgitation volume and fraction were calculated.
- Echocardiographic severity grading was used for comparison.
Main Results:
- Electron-beam CT and cardiac catheterization showed no significant difference in MR volume and fraction quantification.
- Good correlations were observed between both modalities and echocardiography.
- Electron-beam CT demonstrated slightly better correlation with echocardiography than catheterization.
Conclusions:
- Electron-beam CT provides accurate quantification of mitral regurgitation, comparable to cardiac catheterization.
- Both electron-beam CT and cardiac catheterization measurements align well with echocardiographic findings.
- Electron-beam CT is a viable alternative for assessing mitral regurgitation in heart failure.
Objectives:
We sought to determine the agreement between electron-beam computed tomography (CT) and cardiac catheterization for the quantification of mitral regurgitation and to evaluate their association with echocardiographic assessment.
Material And Methods:
Fifty patients with congestive heart failure were examined both by electron-beam CT and catheterization to calculate mitral regurgitation volume and fraction based on the difference between the left ventricular stroke and aortic flow volume. The severity of regurgitation was also compared with visual assessment by echocardiography (grade, 0-4+).
Results:
The mean values for the mitral regurgitation volume and fraction did not differ significantly between electron-beam CT and catheterization (mean differences: 0.2 mL/m2 and -0.9%, P > 0.05 each, limits of agreement: -14.0 to 14.4 mL/m2 and -26.3 to 24.5%, respectively) and showed a good correlation (r = 0.79 and r = 0.76, respectively; P < 0.05 each). Good levels of correlation were observed between echocardiographic severity grading and quantitative measurements of regurgitation volume and fraction, which were somewhat better between echocardiography and electron-beam CT (rS = 0.78 and rS = 0.84, respectively; P < 0.05 each) than between echocardiography and catheterization (rS = 0.72 and rS = 0.81, respectively; P < 0.05 each).
Conclusion:
Our results suggest that electron-beam CT allows for quantification of mitral valve regurgitation with similar accuracy as cardiac catheterization. Measurements with both modalities correlated well with the results of echocardiographic assessment.
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An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...