Usefulness of cardiovascular magnetic resonance imaging for the evaluation of valve opening and closing kinetics in aortic stenosis
Usefulness of cardiovascular magnetic resonance imaging for the evaluation of valve opening and closing kinetics in aortic stenosis
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DOI：
10.1093/ehjci/jes314
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发表时间：
2013-08-01
影响因子：
6.2
通讯作者：
Larose, Eric
中科院分区：
文献类型：
--
作者：
Garcia, Julio;Pibarot, Philippe;Larose, Eric
本研究的目的是：（i）确定通过心血管磁共振（CMR）测量瓣膜动力学参数的可行性和可重复性，以及（ii）检查这些参数与主动脉瓣狭窄（AS）患者的不良预后标志物之间的关联。（0.60 cm（2）EOA 1.90 cm（2））进行了经胸超声心动图（TTE）和CMR。根据CMR获得的瞬时有效瓣口面积（EOA）曲线计算瓣膜打开斜率（OS）和关闭斜率（CS）。观察者内和观察者间变异分别为4.8 3.9和5.0 4.1，OS，3.8 2.9和4.0 3.1 CS。血浆NT-脑钠肽前体（BNP）水平与OS显著相关（r 0.36，P0.002），而与EOA或跨瓣压差无关。需要进行更大规模的研究来确认这些新的主动脉瓣动力学CMR参数对严重AS患者的预后价值。
The aims of this study were : (i) to determine the feasibility and reproducibility of the measurement of valve kinetic parameters by cardiovascular magnetic resonance (CMR) and (ii) to examine the association between these parameters and markers of a poor prognosis in patients with aortic stenosis (AS).Eight healthy control subjects and 71 patients with AS (0.60 cm(2) EOA 1.90 cm(2)) underwent transthoracic echocardiography (TTE) and CMR. The valve opening slope (OS) and closing slope (CS) were calculated from instantaneous effective orifice area (EOA) curves obtained by CMR. Intra- and inter-observer variability were 4.8 3.9 and 5.0 4.1, respectively, for OS, 3.8 2.9 and 4.0 3.1 for CS. OS was significantly related to the plasma level of NT-pro-brain natriuretic peptide (BNP) (r 0.36, P 0.002), whereas the EOA or gradient were not.This study demonstrates the excellent feasibility and reproducibility of CMR for the measurement of valve kinetic parameters in patients with AS. Larger studies are needed to confirm the incremental prognostic value of these new CMR parameters of aortic valve kinetics in patients with severe AS.