Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis

Abstract Background Phase contrast (PC) cardiovascular magnetic resonance (CMR) in the ascending aorta (AAo) is widely used to calculate left ventricular (LV) stroke volume (SV). The accuracy of PC CMR may be altered by turbulent flow. Measurement of SV at another site is suggested in the presence o...

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Autores principales:	Ezequiel Guzzetti, Hugo-Pierre Racine, Lionel Tastet, Mylène Shen, Eric Larose, Marie-Annick Clavel, Philippe Pibarot, Jonathan Beaudoin
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Phase contrast Aortic stenosis Valvular heart disease Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/7521a19402bd40d1889bb9306708b342
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spelling	oai:doaj.org-article:7521a19402bd40d1889bb9306708b3422021-11-07T12:21:55ZAccuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis10.1186/s12968-021-00814-41532-429Xhttps://doaj.org/article/7521a19402bd40d1889bb9306708b3422021-11-01T00:00:00Zhttps://doi.org/10.1186/s12968-021-00814-4https://doaj.org/toc/1532-429XAbstract Background Phase contrast (PC) cardiovascular magnetic resonance (CMR) in the ascending aorta (AAo) is widely used to calculate left ventricular (LV) stroke volume (SV). The accuracy of PC CMR may be altered by turbulent flow. Measurement of SV at another site is suggested in the presence of aortic stenosis, but very few data validates the accuracy or inaccuracy of PC in that setting. Our objective is to compare flow measurements obtained in the AAo and LV outflow tract (LVOT) in patients with aortic stenosis. Methods Retrospective analysis of patients with aortic stenosis who had CMR and echocardiography. Patients with mitral regurgitation were excluded. PC in the AAo and LVOT were acquired to derive SV. LV SV from end-systolic and end-diastolic tracings was used as the reference measure. A difference ≥ 10% between the volumetric method and PC derived SVs was considered discordant. Metrics of turbulence and jet eccentricity were assessed to explore the predictors of discordant measurements. Results We included 88 patients, 41% with bicuspid aortic valve. LVOT SV was concordant with the volumetric method in 79 (90%) patients vs 52 (59%) patients for AAo SV (p = 0.015). In multivariate analysis, aortic stenosis flow jet angle was a strong predictor of discordant measurement in the AAo (p = 0.003). Mathematical correction for the jet angle improved the concordance from 59 to 91%. Concordance was comparable in patients with bicuspid and trileaflet valves (57% and 62% concordance respectively; p = 0.11). Accuracy of SV measured in the LVOT was not influenced by jet eccentricity. For aortic regurgitation quantification, PC in the AAo had better correlation to volumetric assessments than LVOT PC. Conclusion LVOT PC SV in patients with aortic stenosis and eccentric jet might be more accurate compared to the AAo SV. Mathematical correction for the jet angle in the AAo might be another alternative to improve accuracy.Ezequiel GuzzettiHugo-Pierre RacineLionel TastetMylène ShenEric LaroseMarie-Annick ClavelPhilippe PibarotJonathan BeaudoinBMCarticlePhase contrastAortic stenosisValvular heart diseaseDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Phase contrast Aortic stenosis Valvular heart disease Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Phase contrast Aortic stenosis Valvular heart disease Diseases of the circulatory (Cardiovascular) system RC666-701 Ezequiel Guzzetti Hugo-Pierre Racine Lionel Tastet Mylène Shen Eric Larose Marie-Annick Clavel Philippe Pibarot Jonathan Beaudoin Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
description	Abstract Background Phase contrast (PC) cardiovascular magnetic resonance (CMR) in the ascending aorta (AAo) is widely used to calculate left ventricular (LV) stroke volume (SV). The accuracy of PC CMR may be altered by turbulent flow. Measurement of SV at another site is suggested in the presence of aortic stenosis, but very few data validates the accuracy or inaccuracy of PC in that setting. Our objective is to compare flow measurements obtained in the AAo and LV outflow tract (LVOT) in patients with aortic stenosis. Methods Retrospective analysis of patients with aortic stenosis who had CMR and echocardiography. Patients with mitral regurgitation were excluded. PC in the AAo and LVOT were acquired to derive SV. LV SV from end-systolic and end-diastolic tracings was used as the reference measure. A difference ≥ 10% between the volumetric method and PC derived SVs was considered discordant. Metrics of turbulence and jet eccentricity were assessed to explore the predictors of discordant measurements. Results We included 88 patients, 41% with bicuspid aortic valve. LVOT SV was concordant with the volumetric method in 79 (90%) patients vs 52 (59%) patients for AAo SV (p = 0.015). In multivariate analysis, aortic stenosis flow jet angle was a strong predictor of discordant measurement in the AAo (p = 0.003). Mathematical correction for the jet angle improved the concordance from 59 to 91%. Concordance was comparable in patients with bicuspid and trileaflet valves (57% and 62% concordance respectively; p = 0.11). Accuracy of SV measured in the LVOT was not influenced by jet eccentricity. For aortic regurgitation quantification, PC in the AAo had better correlation to volumetric assessments than LVOT PC. Conclusion LVOT PC SV in patients with aortic stenosis and eccentric jet might be more accurate compared to the AAo SV. Mathematical correction for the jet angle in the AAo might be another alternative to improve accuracy.
format	article
author	Ezequiel Guzzetti Hugo-Pierre Racine Lionel Tastet Mylène Shen Eric Larose Marie-Annick Clavel Philippe Pibarot Jonathan Beaudoin
author_facet	Ezequiel Guzzetti Hugo-Pierre Racine Lionel Tastet Mylène Shen Eric Larose Marie-Annick Clavel Philippe Pibarot Jonathan Beaudoin
author_sort	Ezequiel Guzzetti
title	Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
title_short	Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
title_full	Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
title_fullStr	Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
title_full_unstemmed	Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
title_sort	accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7521a19402bd40d1889bb9306708b342
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Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis

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