Multimodality Imaging in Transcatheter Aortic Valve Implantation and Post-Procedural Aortic Regurgitation Comparison Among Cardiovascular Magnetic Resonance, Cardiac Computed Tomography, and Echocardiography

被引：148

作者：

Jabbour, Andrew ^{[2
]}

Ismail, Tevfik F. ^{[2
]}

Moat, Neil ^{[2
]}

Gulati, Ankur ^{[2
]}

Roussin, Isabelle ^{[2
]}

Alpendurada, Francisco ^{[2
]}

Park, Bradley ^{[2
]}

Okoroafor, Francois ^{[2
]}

Asgar, Anita ^{[2
]}

Barker, Sarah ^{[2
]}

Davies, Simon ^{[2
]}

Prasad, Sanjay K. ^{[2
]}

Rubens, Michael ^{[2
]}

Mohiaddin, Raad H. ^{[1
,2
]}

机构：

[1] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, Royal Brompton Hosp, Cardiovasc Magnet Resonance Unit, London SW3 6NP, England

[2] Royal Brompton & Harefield NHS Fdn Trust, London, England

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2011年 / 58卷 / 21期

基金：

英国医学研究理事会;

关键词：

aortic stenosis; cardiac computed tomography; cardiovascular magnetic resonance; transcatheter aortic valve; implantation; transthoracic echocardiography; STENOSIS; REPLACEMENT; ANNULUS; RECOMMENDATIONS; PROSTHESIS; SURGERY; ROOT;

D O I：

10.1016/j.jacc.2011.09.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The purpose of this study was to determine imaging predictors of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) and the agreement and reproducibility of cardiovascular magnetic resonance (CMR), cardiac computed tomography (CCT), and transthoracic echocardiography (TTE) in aortic root assessment. Background The optimal imaging strategy for planning TAVI is unclear with a paucity of comparative multimodality imaging data. The association between aortic root morphology and outcomes after TAVI also remains incompletely understood. Methods A total of 202 consecutive patients assessed by CMR, CCT, and TTE for TAVI were studied. Agreement and variability among and within imaging modalities was assessed by Bland-Altman analysis. Postoperative AR was assessed by TTE. Results Of the 202 patients undergoing TAVI assessment with both CMR and TTE, 133 also underwent CCT. Close agreement was observed between CMR and CCT in dimensions of the aortic annulus (bias, -0.4 mm; 95% limits of agreement: -5.7 to 5.0 mm), and similarly for sinus of Valsalva, sinotubular junction, and ascending aortic measures. Agreement between TTE-derived measures and either CMR or CCT was less precise. Intraobserver and interobserver variability were lowest with CMR. The presence and severity of AR after TAVI were associated with larger aortic valve annulus measurements by both CMR (p = 0.03) and CCT (p = 0.04) but not TTE-derived measures (p = 0.10). Neither CCT nor CMR measures of annulus eccentricity, however, predicted AR after TAVI (p = 0.33 and p = 0.78, respectively). Conclusions In patients undergoing imaging assessment for TAVI, the presence and severity of AR after TAVI were associated with larger aortic annulus measurements by both CMR and CCT, but not TTE. Both CMR and CCT provide highly reproducible information in the assessment of patients undergoing TAVI. (J Am Coll Cardiol 2011;58:2165-73) (C) 2011 by the American College of Cardiology Foundation

引用

页码：2165 / 2173

页数：9

共 19 条

[1] MEASUREMENT IN MEDICINE - THE ANALYSIS OF METHOD COMPARISON STUDIES [J].