Author + information
- Islamiyat Babs Animashaun,
- Edgar Argulian,
- Lillian Aldaia,
- Leo Marcoff,
- Stephen James Horgan,
- Konstantinos P. Koulogiannis,
- Steven Wolff,
- Linda D. Gillam and
- Seth Uretsky
The ASE recommends integrating multiple parameters for assessing mitral regurgitation (MR) severity by echo. The ASE guidelines include an algorithm that highlights criteria considered indicative of definitely mild or definitely severe MR. The purpose of this study was to compare this algorithm to an MRI reference standard assessment of MR.
We prospectively enrolled 169 (63 ± 13 yrs, 60 % male) pts with MR in a multicenter study in which subjects underwent ASE algorithm-guided echo and MRI grading of MR severity. Each pt was graded as definitely mild, grade I mild, grade II/III moderate, grade III/IV severe, or definitely severe MR. MRI regurgitant volume was used to grade MR as mild <30ml, moderate 30-59ml, or severe ≥60ml.
By echo 5 (3%) had definitely mild, 38 (23%) grade I mild, 47 (28%) grade II/III moderate, 38 (23%) grade III/IV severe, and 41 (24%) definitely severe MR. By MRI, 80 (47%) patients had mild, 56 (33%) moderate, and 33 (20%) severe MR. All pts classified as definitely mild by echo were mild by MRI (Figure). Only 46% of those classified as definitely severe by echo were severe by MRI. The sensitivity, specificity, PPV and NPV of the definitely severe by echo to predict severe MR by MRI was 58%, 83% 46%, and 89% respectively.
Agreement between MRI and the ASE algorithm was excellent for mild MR but poor for moderate and severe MR. These findings are concerning given the importance of diagnosing severe MR when considering referral for mitral valve surgery.
Moderated Poster Contributions
Valvular Heart Disease and Vascular Medicine Moderated Poster Theater, Posters, Hall A
Monday, March 30, 2020, 12:30 p.m.-12:40 p.m.
Session Title: Mitral Valve Regurgitation: The Valve and the Ventricle; Grading, Staging and Relationship to Outcomes.
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1093-03
- 2020 American College of Cardiology Foundation