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<p>Accurate grading of aortic regurgitation (AR) severity is crucial for treatment decisions. This study aimed to determine whether phase contrast cardiac magnetic resonance (PC-CMR) in the descending aorta can be used as a supporting reference for grading of the AR severity in patients with chronic AR. PC-CMR was performed both in the ascending and descending aorta of 191 AR-patients. Regurgitation thresholds in the descending aorta for hemodynamically significant AR [regurgitation volume (RVol)<sub>DA</sub> and fraction (RF)<sub>DA</sub>] were determined in 41 well-controlled patients and then validated in a cohort surveyed for AR in our clinic. Myerson’s outcome-based thresholds (RVol &gt; 42 mL, RF &gt; 33%) served as reference. For comparison, holodiastolic flow reversal (HFR) was determined. Regurgitation measurements in the descending and ascending aorta were strongly correlated (RVol: <i>R</i> ≥ 0.92; RF: <i>R</i> ≥ 0.85; <i>p</i> &lt; 0.001). Diagnostic performance of RVol<sub>DA</sub>&gt;17 mL and RF<sub>DA</sub>&gt;23% was high (sensitivity: 92%, 83%; specificity: 95%, 93%) and more patients with significant AR were identified using these PC-MRI based thresholds [RVol<sub>DA</sub>&gt;17mL (13%) and RF<sub>DA</sub>&gt;23% (15%)] than with HFR alone. PC-CMR in the descending aorta has the potential to reliably grade AR severity in patients with chronic AR and thereby may serve as a supportive reference in the decision-making regarding optimal timing of intervention.</p>

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Phase contrast CMR in the descending aorta as a supportive reference for severe aortic regurgitation

  • 期刊论文

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  • 发表日期：

    2025年12月24日

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  • Frida Truedsson,
  • Sinsia A. Gao,
  • Christian L. Polte,
  • Odd Bech-Hanssen,
  • Åse A. Johnsson,
  • Kerstin M. Lagerstrand

摘要

Accurate grading of aortic regurgitation (AR) severity is crucial for treatment decisions. This study aimed to determine whether phase contrast cardiac magnetic resonance (PC-CMR) in the descending aorta can be used as a supporting reference for grading of the AR severity in patients with chronic AR. PC-CMR was performed both in the ascending and descending aorta of 191 AR-patients. Regurgitation thresholds in the descending aorta for hemodynamically significant AR [regurgitation volume (RVol)DA and fraction (RF)DA] were determined in 41 well-controlled patients and then validated in a cohort surveyed for AR in our clinic. Myerson’s outcome-based thresholds (RVol > 42 mL, RF > 33%) served as reference. For comparison, holodiastolic flow reversal (HFR) was determined. Regurgitation measurements in the descending and ascending aorta were strongly correlated (RVol: R ≥ 0.92; RF: R ≥ 0.85; p < 0.001). Diagnostic performance of RVolDA>17 mL and RFDA>23% was high (sensitivity: 92%, 83%; specificity: 95%, 93%) and more patients with significant AR were identified using these PC-MRI based thresholds [RVolDA>17mL (13%) and RFDA>23% (15%)] than with HFR alone. PC-CMR in the descending aorta has the potential to reliably grade AR severity in patients with chronic AR and thereby may serve as a supportive reference in the decision-making regarding optimal timing of intervention.