Aortic regurgitation cardiac MRI: Difference between revisions

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{{Aortic insufficiency}}
{{Aortic insufficiency}}
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==Overview==
==Overview==
Cardiac MRI may be used in the assessment of individuals with [[valvular heart disease]] among whom the evaluation of valvular stenosis, regurgitation, para- or perivalvular masses, perivalvular complications of infectious processes, or [[prosthetic valve]] disease is needed.  Cardiovascular magnetic resonance (CMR) may be useful in identifying serial changes in [[LV]] volumes or mass in patients with valvular dysfunction. Among patients with suboptimal [[echocardiogram]]s, [[magnetic resonance imaging]] is used to to determine the severity of [[AR]] and assess [[left ventricular]] volume and function at rest. CMR can also be used to determine the severity of [[AR]] in patients with suboptimal [[echocardiogram]]s.
[[Cardiac MRI]] may be used in the assessment of individuals with [[valvular heart disease]] among whom the evaluation of valvular stenosis, regurgitation, para- or perivalvular masses, perivalvular complications of infectious processes, or [[prosthetic valve]] disease is needed.  [[Cardiac magnetic resonance|Cardiovascular magnetic resonance]] (CMR) may be useful in the identification of serial changes in [[left ventricular]] volume or mass among patients with valvular dysfunction. Among patients with suboptimal [[echocardiogram]]s, [[magnetic resonance imaging]] is used to to determine the severity of [[AR]] and assess [[left ventricular]] volume and function at rest.<ref name="pmid27491900">{{cite journal| author=Ribeiro HB, Orwat S, Hayek SS, Larose É, Babaliaros V, Dahou A et al.| title=Cardiovascular Magnetic Resonance to Evaluate Aortic Regurgitation After Transcatheter Aortic Valve Replacement. | journal=J Am Coll Cardiol | year= 2016 | volume= 68 | issue= 6 | pages= 577-85 | pmid=27491900 | doi=10.1016/j.jacc.2016.05.059 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27491900  }} </ref><ref name="pmid24603191">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2014 | volume= 63 | issue= 22 | pages= e57-185 | pmid=24603191 | doi=10.1016/j.jacc.2014.02.536 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24603191  }} </ref><ref name="pmid21784393">{{cite journal| author=Gabriel RS, Renapurkar R, Bolen MA, Verhaert D, Leiber M, Flamm SD et al.| title=Comparison of severity of aortic regurgitation by cardiovascular magnetic resonance versus transthoracic echocardiography. | journal=Am J Cardiol | year= 2011 | volume= 108 | issue= 7 | pages= 1014-20 | pmid=21784393 | doi=10.1016/j.amjcard.2011.05.034 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21784393  }} </ref><ref name="pmid19652976">{{cite journal| author=Goffinet C, Kersten V, Pouleur AC, le Polain de Waroux JB, Vancraeynest D, Pasquet A et al.| title=Comprehensive assessment of the severity and mechanism of aortic regurgitation using multidetector CT and MR. | journal=Eur Radiol | year= 2010 | volume= 20 | issue= 2 | pages= 326-36 | pmid=19652976 | doi=10.1007/s00330-009-1544-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19652976  }} </ref><ref name="pmid17686805">{{cite journal| author=Debl K, Djavidani B, Buchner S, Heinicke N, Fredersdorf S, Haimerl J et al.| title=Assessment of the anatomic regurgitant orifice in aortic regurgitation: a clinical magnetic resonance imaging study. | journal=Heart | year= 2008 | volume= 94 | issue= 3 | pages= e8 | pmid=17686805 | doi=10.1136/hrt.2006.108720 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17686805  }} </ref>
 
== 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines<ref name="pmid33332150">{{cite journal| author=Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F | display-authors=etal| title=2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2021 | volume= 143 | issue= 5 | pages= e72-e227 | pmid=33332150 | doi=10.1161/CIR.0000000000000923 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33332150  }}</ref> ==
 
 
Because of the instability of the patient, MRI is rarely employed in the acute environment.
 


==2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Diseases (DO NOT EDIT)<ref>{{Cite web  | last =  | first =  | title = 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary | url = http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000029.full.pdf+html | publisher =  | date =  | accessdate = 4 March 2014 }}</ref>==
==2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Diseases (DO NOT EDIT)<ref>{{Cite web  | last =  | first =  | title = 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary | url = http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000029.full.pdf+html | publisher =  | date =  | accessdate = 4 March 2014 }}</ref>==
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| colspan="1" style="text-align:center; background:LightGreen"|[[EHS ESC guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[CMR]] is indicated in patients with moderate or severe AR (stages B, C, and D) and suboptimal echocardiographic images for the assessment of [[LV]] systolic function, [[systolic]] and [[diastolic]] volumes, and measurement of AR severity. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) ''<nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[CMR]] is indicated in patients with moderate or severe AR (stages B, C, and D) and suboptimal echocardiographic images for the assessment of [[LV]] systolic function, [[systolic]] and [[diastolic]] volumes, and measurement of AR severity. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]]) ''<nowiki>"</nowiki>
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==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[CME Category::Cardiology]]
[[Category:Disease]]
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[[Category:Cardiology]]
[[Category:Cardiology]]
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[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]
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Latest revision as of 13:01, 8 December 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Cardiac MRI may be used in the assessment of individuals with valvular heart disease among whom the evaluation of valvular stenosis, regurgitation, para- or perivalvular masses, perivalvular complications of infectious processes, or prosthetic valve disease is needed. Cardiovascular magnetic resonance (CMR) may be useful in the identification of serial changes in left ventricular volume or mass among patients with valvular dysfunction. Among patients with suboptimal echocardiograms, magnetic resonance imaging is used to to determine the severity of AR and assess left ventricular volume and function at rest.[1][2][3][4][5]

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[6]

Because of the instability of the patient, MRI is rarely employed in the acute environment.


2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Diseases (DO NOT EDIT)[7]

Diagnosis and Follow Up

Class I
"1. CMR is indicated in patients with moderate or severe AR (stages B, C, and D) and suboptimal echocardiographic images for the assessment of LV systolic function, systolic and diastolic volumes, and measurement of AR severity. (Level of Evidence: B) "

2010 ACCF/ACR/AHA/NASCI/SCMR Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)[8]

Cardiac MRI in Valvular Heart Disease (DO NOT EDIT)[8]

“

CMR may be used for assessing individuals with valvular heart disease in which evaluation of valvular stenosis, regurgitation, para- or perivalvular masses, perivalvular complications of infectious processes, or prosthetic valve disease are needed. CMR may be useful in identifying serial changes in LV volumes or mass in patients with valvular dysfunction.

”

2008 Focused Update Incorporated Into the 2006 ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease (DO NOT EDIT)[9]

Cardiac MRI (DO NOT EDIT)[9]

Class I
"1. Radionuclide angiography or magnetic resonance imaging is indicated for the initial and serial assessment of LV volume and function at rest in patients with AR and suboptimal echocardiograms. (Level of Evidence: B)"
Class IIa
"1. Magnetic resonance imaging is reasonable for the estimation of AR severity in patients with unsatisfactory echocardiograms. (Level of Evidence: B)"

Sources

  • 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease[9]
  • 2010 ACCF/ACR/AHA/NASCI/SCMR expert consensus document on cardiovascular magnetic resonance[8]

References

  1. ↑ Ribeiro HB, Orwat S, Hayek SS, Larose É, Babaliaros V, Dahou A; et al. (2016). "Cardiovascular Magnetic Resonance to Evaluate Aortic Regurgitation After Transcatheter Aortic Valve Replacement". J Am Coll Cardiol. 68 (6): 577–85. doi:10.1016/j.jacc.2016.05.059. PMID 27491900.
  2. ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID 24603191.
  3. ↑ Gabriel RS, Renapurkar R, Bolen MA, Verhaert D, Leiber M, Flamm SD; et al. (2011). "Comparison of severity of aortic regurgitation by cardiovascular magnetic resonance versus transthoracic echocardiography". Am J Cardiol. 108 (7): 1014–20. doi:10.1016/j.amjcard.2011.05.034. PMID 21784393.
  4. ↑ Goffinet C, Kersten V, Pouleur AC, le Polain de Waroux JB, Vancraeynest D, Pasquet A; et al. (2010). "Comprehensive assessment of the severity and mechanism of aortic regurgitation using multidetector CT and MR". Eur Radiol. 20 (2): 326–36. doi:10.1007/s00330-009-1544-x. PMID 19652976.
  5. ↑ Debl K, Djavidani B, Buchner S, Heinicke N, Fredersdorf S, Haimerl J; et al. (2008). "Assessment of the anatomic regurgitant orifice in aortic regurgitation: a clinical magnetic resonance imaging study". Heart. 94 (3): e8. doi:10.1136/hrt.2006.108720. PMID 17686805.
  6. ↑ Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F; et al. (2021). "2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 143 (5): e72–e227. doi:10.1161/CIR.0000000000000923. PMID 33332150 Check |pmid= value (help).
  7. ↑ "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
  8. ↑ 8.0 8.1 8.2 American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA; et al. (2010). "ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents". Circulation. 121 (22): 2462–508. doi:10.1161/CIR.0b013e3181d44a8f. PMC 3034132. PMID 20479157.
  9. ↑ 9.0 9.1 9.2 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter |month= ignored (help)

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