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Updated: Jun 18, 2025
In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
Published on: February 25, 2022
Prognostic Value of Cardiac Magnetic Resonance Imaging in Chronic Aortic Regurgitation: A Systematic Review and
Jin-Rong Ni1,2,3,4,5, Wen-Long Xin3,4,5,6, Yuan Hu2
1The First Hospital (First Clinical Medical School) of Lanzhou University, 730000 Lanzhou, Gansu, China.
Insights
Cardiac magnetic resonance (CMR) effectively predicts prognosis in chronic aortic regurgitation (AR) patients. Key parameters like aortic regurgitation fraction (ARF), left ventricle end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) guide timely interventions.
Area of Science:
- Cardiovascular Imaging
- Valvular Heart Disease
- Cardiac Magnetic Resonance
Background:
- Chronic aortic regurgitation (AR) leads to left ventricular volume and pressure overload.
- Accurate cardiac assessment is vital for managing AR patients and predicting outcomes.
- Cardiac magnetic resonance (CMR) is the gold standard for evaluating cardiac volume and function.
Purpose of the Study:
- To evaluate the prognostic value of cardiac magnetic resonance (CMR) in patients with chronic aortic regurgitation (AR).
- To identify CMR-derived parameters that predict the need for aortic valve surgery in AR patients.
Main Methods:
- A systematic literature search was conducted across EMBASE, Cochrane Library, PubMed, and Web of Science.
- Included studies used CMR to assess chronic isolated AR patients with available prognostic data.
- Eleven studies involving 1702 subjects with follow-up periods of 0.6-9.7 years were analyzed.
Main Results:
- Thirteen CMR parameters were associated with AR prognosis.
- Aortic regurgitation fraction (ARF), left ventricle end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV) showed significant prognostic value for aortic valve surgery.
- Pooled hazard ratios indicated increased risk with higher ARF, LVEDV, and LVESV.
Conclusions:
- CMR assessment of ARF, LVEDV, and LVESV provides significant prognostic information for AR patients.
- Multi-parameter CMR assessment is recommended for clinical management and timely intervention in AR.
- Utilizing CMR aids in effective prognostic evaluation and guides therapeutic decisions for AR patients.
Background:
Chronic aortic regurgitation (AR) is a common valvular disease characterized by an overload of left ventricular volume and pressure. Accurate assessment of the heart from all angles is crucial for effective clinical management and prognostic evaluation of AR patients. As an advanced imaging technique, cardiac magnetic resonance (CMR) has become the gold standard for assessing cardiac volume and function. Accordingly, this study aimed to evaluate the prognostic value of CMR in chronic AR.
Methods:
EMBASE, Cochrane Library, PubMed, and Web of Science were searched for clinical studies published between inception and July 19, 2022. Only studies that used CMR to assess patients with chronic isolated AR and provided prognostic data were included.
Results:
For our analysis, 11 studies, which involved 1702 subjects and follow-up periods of 0.6-9.7 years, were eligible. We identified 13 CMR-related parameters associated with AR prognosis. With aortic valve surgery as the outcome, we estimated the pooled hazard ratios (HRs) for four of these parameters: aortic regurgitation fraction (ARF), aortic regurgitation volume (ARV), left ventricle end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV). The pooled HR for ARF was found to be 4.31 (95% confidence interval [CI]: 1.12-16.59, p = 0.034), while that for ARV was 3.88 (95% CI: 0.71-21.04, p = 0.116). Additionally, the combined HRs of LVEDV and LVESV were estimated to be 2.20 (95% CI: 1.04-4.67, p = 0.039) and 3.14 (95% CI: 1.22-8.07, p = 0.018), respectively.
Conclusions:
The assessment of ARF, LVEDV, and LVESV via CMR has significant prognostic value in predicting the prognosis of AR patients with aortic valve surgery as an endpoint. It is recommended to consider using multi-parameter CMR in the clinical management of AR patients for timely interventions and effective prognostic evaluation.
