Magnetic resonance imaging assessment of the severity of mitral regurgitation. Comparison with invasive techniques.

BACKGROUND In the patient with mitral regurgitation who is being considered for valvular surgery, cardiac catheterization is usually performed to quantify the severity of regurgitation and to determine its influence on left ventricular volumes and systolic function. Magnetic resonance imaging (MRI) potentially provides a rapid, noninvasive method of acquiring these data. Thus, this study was done to determine whether MRI can reliably measure the magnitude of mitral regurgitation and evaluate the effect of regurgitation on left ventricular volumes and systolic function. METHODS AND RESULTS Twenty-three subjects (14 women and 9 men 15 to 72 years of age) with (n = 17) or without (n = 6) mitral regurgitation underwent MRI scanning followed immediately by cardiac catheterization. The presence (or absence) of valvular regurgitation was determined, and left ventricular volumes and regurgitant fraction were quantified during each procedure. There was excellent correlation between invasive and MRI assessments of left ventricular end-diastolic (r = .95) and end-systolic (r = .95) volumes and regurgitant fraction (r = .96). All MRI examinations were completed in < 28 minutes. CONCLUSIONS In the patient with mitral regurgitation, MRI compares favorably with cardiac catheterization for assessment of the magnitude of regurgitation and its influence on left ventricular volumes and systolic function.

[1]  C. Sampson Cardiovascular applications of magnetic resonance: Gerald M. Pohost Futura Publishing Co., Mount Kisco, New York; 459 pp.; US$86.00; ISBN 0-87993-548-0 , 1994 .

[2]  C. Higgins,et al.  Quantification of mitral regurgitation by velocity-encoded cine nuclear magnetic resonance imaging. , 1994, Journal of the American College of Cardiology.

[3]  C Baldy,et al.  Automated myocardial edge detection from breath-hold cine-MR images: evaluation of left ventricular volumes and mass. , 1994, Magnetic resonance imaging.

[4]  R. Peshock,et al.  Automated system for blood flow measurement using MR velocity sensitive imaging , 1993, Proceedings of the 15th Annual International Conference of the IEEE Engineering in Medicine and Biology Societ.

[5]  B. A. Carbello,et al.  Mitral valve disease. , 1993, Current problems in cardiology.

[6]  O Henriksen,et al.  Quantification of aortic regurgitation by magnetic resonance velocity mapping. , 1993, American heart journal.

[7]  N J Pelc,et al.  Magnetic Resonance Imaging of Blood Flow with a Phase Subtraction Technique: In Vitro and In Vivo Validation , 1993, Investigative radiology.

[8]  N. Yoshimoto,et al.  Aortic regurgitation: quantitation with MR imaging velocity mapping. , 1993, Radiology.

[9]  L. Hillis,et al.  Comparison of single and biplane ventriculography for determination of left ventricular volume and ejection fraction. , 1992, The American journal of cardiology.

[10]  M. Swindle,et al.  Depressed contractile function due to canine mitral regurgitation improves after correction of the volume overload. , 1991, The Journal of clinical investigation.

[11]  J Valk,et al.  An in vivo validation of quantitative blood flow imaging in arteries and veins using magnetic resonance phase-shift techniques. , 1991, European heart journal.

[12]  William Grossman,et al.  Cardiac Catheterization, Angiography, and Intervention , 1990 .

[13]  G M Pohost,et al.  Left ventricular volume measurement using cardiac axis nuclear magnetic resonance imaging. Validation by calibrated ventricular angiography. , 1990, Circulation.

[14]  K. Hammermeister,et al.  Clinical Investigation Determinants of Survival and Left Ventricular Performance After Mitral Valve Replacement , 2005 .

[15]  N. Reichek,et al.  Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. , 1989, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[16]  J. Spann,et al.  Left ventricular function in experimental volume overload hypertrophy. , 1989, The American journal of physiology.

[17]  A. Demaria,et al.  Quantitative assessment of mitral regurgitation by Doppler color flow imaging: angiographic and hemodynamic correlations. , 1989, Journal of the American College of Cardiology.

[18]  J Valk,et al.  Evaluation of magnetic resonance imaging for determination of left ventricular ejection fraction and comparison with angiography. , 1988, The American journal of cardiology.

[19]  I. Kronzon,et al.  The Contribution of Magnetic Resonance Imaging to the Evaluation of Intracardiac Tumors Diagnosed by Echocardiography , 1988, Circulation.

[20]  W. R. Kennedy,et al.  Magnetic Resonance Imaging of the Cardiovascular System: Present State of the Art and Future Potential , 1988 .

[21]  C. Higgins,et al.  Suspected intracardiac masses: evaluation with MR imaging. , 1987, Radiology.

[22]  N. Reichek,et al.  Early postoperative changes in left ventricular chamber size, architecture, and function in aortic stenosis and aortic regurgitation and their relation to intraoperative changes in afterload: a prospective two-dimensional echocardiographic study. , 1987, Circulation.

[23]  R G Gould,et al.  Measurement of right and left ventricular volumes in healthy individuals with cine MR imaging. , 1987, Radiology.

[24]  N. Nanda,et al.  Color Doppler assessment of mitral regurgitation with orthogonal planes. , 1987, Circulation.

[25]  M. Winniford,et al.  Comparison of thermodilution and indocyanine green dye in low cardiac output or left-sided regurgitation. , 1986, American Journal of Cardiology.

[26]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[27]  M. Winniford,et al.  Analysis of factors affecting the variability of Fick versus indicator dilution measurements of cardiac output. , 1985, The American journal of cardiology.

[28]  L. Kaufman,et al.  Magnetic resonance imaging of the cardiovascular system. , 1985, Magnetic resonance annual.

[29]  M. Winniford,et al.  Limitations of qualitative angiographic grading in aortic or mitral regurgitation. , 1984, The American journal of cardiology.

[30]  M. Winniford,et al.  Left ventricular volumes by single-plane cineangiography: in vivo validation of the Kennedy regression equation. , 1984, The American journal of cardiology.

[31]  J. Carroll,et al.  Chronic mitral regurgitation: predictive value of preoperative echocardiographic indexes of left ventricular function and wall stress. , 1984, Journal of the American College of Cardiology.

[32]  L. Hillis,et al.  Oxygen consumption in adult patients during cardiac catheterization , 1982, Clinical cardiology.

[33]  E. Braunwald,et al.  End-systolic volume as a predictor of postoperative left ventricular performance in volume overload from valvular regurgitation. , 1980, The American journal of medicine.

[34]  J. Ross,et al.  Temporal Response of Left Ventricular Performance to Mitral Valve Surgery , 1979, Circulation.

[35]  W Grossman,et al.  Estimation of left ventricular volumes in man from biplane cineangiograms filmed in oblique projections. , 1978, The American journal of cardiology.

[36]  W Grossman,et al.  Wall stress and patterns of hypertrophy in the human left ventricle. , 1975, The Journal of clinical investigation.

[37]  William Grossman,et al.  Cardiac catheterization and angiography , 1974 .

[38]  J W Covell,et al.  Diastolic Geometry and Sarcomere Lengths in the Chronically Dilated Canine Left Ventricle , 1971, Circulation research.

[39]  J. W. Kennedy,et al.  Left ventricular volume and mass from single-plane cineangiocardiogram. A comparison of anteroposterior and right anterior oblique methods. , 1970, American heart journal.

[40]  H. Dodge,et al.  The use of biplane angiocardigraphy for the measurement of left ventricular volume in man. , 1960, American heart journal.