ElTahlawy Walid Ms, Ragab Tamer M, Elkhashab Khaled A, Ebeid Hassan M
Heart and Vascular Institute, Cardiology department, Cleveland Clinic Abu Dhabi, 112412 Abu Dhabi, United Arab of Emirates.
Cardiology Department, Faculty of Medicice, AlFayoum University, 63514 AlFayoum, Egypt.
Rev Cardiovasc Med. 2021 Mar 30;22(1):215-223. doi: 10.31083/j.rcm.2021.01.20216.
Both Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) have well-established role in mitral regurgitation (MR) quantification for optimal management strategy. We assessed the correlation between TTE and CMR in the quantification of MR. Participants with isolated MR and echocardiographic mitral regurgitant volume (RVol) ≥ 30 mL/beat were included. A consecutive sample of 30 participants (Mean age 52.7 ± 19.3 years, 50% males) was selected and referred for indirect and direct CMR quantification of mitral RVol. There was a statistically significant strong positive correlation between the echocardiographic and indirect CMR quantification of the mitral RVol (r = 0.753, < 0.001) and a statistically significant moderate positive correlation between the echocardiographic and direct CMR quantification of the mitral RVol (r = 0.530, < 0.003). The inter-observer reliability of the MR grade between TTE and CMR showed a statistically significant moderate agreement (κ = 0.502, = 0.0001) when the observers used the echocardiographic mitral RVol for grading of MR. On the other hand, the inter-observer reliability of the MR grade between TTE and CMR showed a statistically significant faint agreement (κ = 0.251, = 0.024) when the observers used the echocardiographic regurgitant fraction (RF) for grading of MR. The positive reciprocal relationship between the CMR and the TTE highlights the potential role of the CMR as a concomitant imaging tool for quantification of the mitral RVol and grading of isolated MR, especially with limited or inconclusive TTE studies. This will enhance the management strategy and improve outcomes.
经胸超声心动图(TTE)和心脏磁共振成像(CMR)在二尖瓣反流(MR)定量分析以制定最佳管理策略方面均具有公认的作用。我们评估了TTE和CMR在MR定量分析中的相关性。纳入孤立性MR且超声心动图二尖瓣反流容积(RVol)≥30 mL/搏的参与者。选取30名参与者的连续样本(平均年龄52.7±19.3岁,50%为男性),并转诊进行二尖瓣RVol的间接和直接CMR定量分析。二尖瓣RVol的超声心动图和间接CMR定量分析之间存在统计学显著的强正相关(r = 0.753,<0.001),二尖瓣RVol的超声心动图和直接CMR定量分析之间存在统计学显著的中度正相关(r = 0.530,<0.003)。当观察者使用超声心动图二尖瓣RVol对MR进行分级时,TTE和CMR之间MR分级的观察者间可靠性显示出统计学显著的中度一致性(κ = 0.502,= 0.0001)。另一方面,当观察者使用超声心动图反流分数(RF)对MR进行分级时,TTE和CMR之间MR分级的观察者间可靠性显示出统计学显著的微弱一致性(κ = 0.251,= 0.024)。CMR和TTE之间的正相关关系突出了CMR作为一种辅助成像工具在二尖瓣RVol定量分析和孤立性MR分级中的潜在作用,尤其是在TTE研究有限或结果不确定的情况下。这将加强管理策略并改善治疗结果。