Related Experiment Video

Updated: Jan 6, 2026

In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging
11:16

In vitro Assessment of Aortic Regurgitation Using Four-Dimensional Flow Magnetic Resonance Imaging

Published on: February 25, 2022

3.7K

Diagnostic COncordance in Aortic Regurgitation Severity AssessMent: A ComPARative Study Between Cardiologists With

Giacomo Maria Viani1, Hekuran Bytyci1, Vincenzo Viccaro1

  • 1Department of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.

Echocardiography (Mount Kisco, N.Y.)
|November 6, 2025
PubMed

Insights

Vena contracta width (VCW) is the most reproducible echocardiographic measure for chronic aortic regurgitation (AR). Cardiac magnetic resonance (CMR) offers superior reproducibility and should complement transthoracic echocardiography (TTE) when AR assessment is unclear.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Tools

Background:

  • Accurate assessment of chronic aortic regurgitation (AR) using echocardiography presents challenges due to interobserver variability.
  • Guideline-recommended echocardiographic parameters require evaluation for reproducibility in clinical practice.

Purpose of the Study:

  • To evaluate the reproducibility of guideline-recommended echocardiographic parameters for chronic AR in real-world settings.
  • To assess cardiac magnetic resonance (CMR) as a complementary imaging modality for AR assessment.

Main Methods:

  • Retrospective analysis of 99 patients with AR evaluated by transthoracic echocardiography (TTE).
  • A subset of 22 patients also underwent CMR.
  • AR severity was graded using parameters like pressure half-time (PHT), vena contracta width (VCW), and regurgitant orifice area (EROA), with interobserver agreement assessed via Cohen's Kappa and Bland-Altman analysis.

Main Results:

  • VCW demonstrated the highest reproducibility (overall κ=0.77) and feasibility (68.7%).
  • PHT showed poor interobserver consistency (overall κ=0.36) with significant variability.
  • EROA had moderate agreement (overall κ=0.55) but low feasibility (30.3%).
  • CMR parameters exhibited excellent reproducibility, independent of reader expertise.

Conclusions:

  • VCW is the most reliable echocardiographic parameter for AR assessment.
  • PHT and EROA are limited by variability and feasibility, respectively.
  • CMR offers superior reproducibility and should be considered early for inconclusive TTE findings in chronic AR management.
Abstract

Keywords:
aortic regurgitationcardiovascular magnetic resonancepressure half‐timeproximal isovelocity surface areatransthoracic echocardiographyvena contracta width

More Related Videos

Modified Heterotopic Abdominal Heart Transplantation and a Novel Aortic Regurgitation Model in Rats13:32

Modified Heterotopic Abdominal Heart Transplantation and a Novel Aortic Regurgitation Model in Rats

Published on: June 2, 2023

2.5K
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.9K

Related Concept Videos

Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
361
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
423
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
359
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
435
Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

Mitral Regurgitation II: Clinical Features and Diagnostic Tests

Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
313
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
252