Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography

Dimitrios Maragiannis; Matthew S. Jackson; Kyle Autry; Jose H. Flores Arredondo; Constantina Aggeli; Dimitrios Tousoulis; William A. Zoghbi; Dipan J. Shah; Stephen H. Little

doi:10.1186/s12968-020-00635-x

Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography

Dimitrios Maragiannis, Matthew S. Jackson, Kyle Autry, Jose H. Flores Arredondo, Constantina Aggeli, Dimitrios Tousoulis, William A. Zoghbi, Dipan J. Shah, Stephen H. Little

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

BACKGROUND: A comprehensive non-invasive evaluation of bioprosthetic mitral valve (BMV) function can be challenging. We describe a novel method to assess BMV effective orifice area (EOA) based on phase contrast (PC) cardiovascular magnetic resonance (CMR) data. We compare the performance of this new method to Doppler and in vitro reference standards.

METHODS: Four sizes of normal BMVs (27, 29, 31, 33 mm) and 4 stenotic BMVs (27 mm and 29 mm, with mild or severe leaflet obstruction) were evaluated using a CMR- compatible flow loop. BMVs were evaluated with PC-CMR and Doppler methods under flow conditions of; 70 mL, 90 mL and 110 mL/beat (n = 24). PC-EOA was calculated as PC-CMR flow volume divided by the PC- time velocity integral (TVI).

RESULTS: PC-CMR measurements of the diastolic peak velocity and TVI correlated strongly with Doppler values (r = 0.99, P < 0.001 and r = 0.99, P < 0.001, respectively). Across all conditions tested, the Doppler and PC-CMR measurement of EOA (1.4 ± 0.5 vs 1.5 ± 0.7 cm 2, respectively) correlated highly (r = 0.99, P < 0.001), with a minimum bias of 0.13 cm 2, and narrow limits of agreement (- 0.2 to 0.5 cm 2).

CONCLUSION: We describe a novel method to assess BMV function based on PC measures of transvalvular flow volume and velocity integration. PC-CMR methods can be used to accurately measure EOA for both normal and stenotic BMV's and may provide an important new parameter of BMV function when Doppler methods are unobtainable or unreliable.

Original language	English (US)
Article number	55
Pages (from-to)	55
Journal	Journal of Cardiovascular Magnetic Resonance
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12968-020-00635-x
State	Published - Jul 30 2020

Keywords

Cardiovascular magnetic resonance; bioprosthetic valve
Doppler echocardiography
Mitral valve
Prosthetic valve stenosis
Predictive Value of Tests
Reproducibility of Results
Heart Valve Prosthesis
Humans
Mitral Valve/diagnostic imaging
Bioprosthesis
Echocardiography, Doppler, Color
Prosthesis Design
Feasibility Studies
Magnetic Resonance Imaging
Heart Valve Prosthesis Implantation/adverse effects
Blood Flow Velocity
Mitral Valve Stenosis/diagnostic imaging
Hemodynamics
Observer Variation

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Radiological and Ultrasound Technology
Radiology Nuclear Medicine and imaging

Access to Document

10.1186/s12968-020-00635-x

Cite this

Maragiannis, D., Jackson, M. S., Autry, K., Flores Arredondo, J. H., Aggeli, C., Tousoulis, D., Zoghbi, W. A., Shah, D. J., & Little, S. H. (2020). Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography. Journal of Cardiovascular Magnetic Resonance, 22(1), 55. Article 55. https://doi.org/10.1186/s12968-020-00635-x

Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography. / Maragiannis, Dimitrios; Jackson, Matthew S.; Autry, Kyle et al.
In: Journal of Cardiovascular Magnetic Resonance, Vol. 22, No. 1, 55, 30.07.2020, p. 55.

Research output: Contribution to journal › Article › peer-review

Maragiannis, D, Jackson, MS, Autry, K, Flores Arredondo, JH, Aggeli, C, Tousoulis, D, Zoghbi, WA , Shah, DJ & Little, SH 2020, 'Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography', Journal of Cardiovascular Magnetic Resonance, vol. 22, no. 1, 55, pp. 55. https://doi.org/10.1186/s12968-020-00635-x

@article{80a6d3e7089b4996900325326a239638,

title = "Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography",

abstract = "BACKGROUND: A comprehensive non-invasive evaluation of bioprosthetic mitral valve (BMV) function can be challenging. We describe a novel method to assess BMV effective orifice area (EOA) based on phase contrast (PC) cardiovascular magnetic resonance (CMR) data. We compare the performance of this new method to Doppler and in vitro reference standards.METHODS: Four sizes of normal BMVs (27, 29, 31, 33 mm) and 4 stenotic BMVs (27 mm and 29 mm, with mild or severe leaflet obstruction) were evaluated using a CMR- compatible flow loop. BMVs were evaluated with PC-CMR and Doppler methods under flow conditions of; 70 mL, 90 mL and 110 mL/beat (n = 24). PC-EOA was calculated as PC-CMR flow volume divided by the PC- time velocity integral (TVI).RESULTS: PC-CMR measurements of the diastolic peak velocity and TVI correlated strongly with Doppler values (r = 0.99, P < 0.001 and r = 0.99, P < 0.001, respectively). Across all conditions tested, the Doppler and PC-CMR measurement of EOA (1.4 ± 0.5 vs 1.5 ± 0.7 cm 2, respectively) correlated highly (r = 0.99, P < 0.001), with a minimum bias of 0.13 cm 2, and narrow limits of agreement (- 0.2 to 0.5 cm 2). CONCLUSION: We describe a novel method to assess BMV function based on PC measures of transvalvular flow volume and velocity integration. PC-CMR methods can be used to accurately measure EOA for both normal and stenotic BMV's and may provide an important new parameter of BMV function when Doppler methods are unobtainable or unreliable.",

keywords = "Cardiovascular magnetic resonance; bioprosthetic valve, Doppler echocardiography, Mitral valve, Prosthetic valve stenosis, Predictive Value of Tests, Reproducibility of Results, Heart Valve Prosthesis, Humans, Mitral Valve/diagnostic imaging, Bioprosthesis, Echocardiography, Doppler, Color, Prosthesis Design, Feasibility Studies, Magnetic Resonance Imaging, Heart Valve Prosthesis Implantation/adverse effects, Blood Flow Velocity, Mitral Valve Stenosis/diagnostic imaging, Hemodynamics, Observer Variation",

author = "Dimitrios Maragiannis and Jackson, {Matthew S.} and Kyle Autry and {Flores Arredondo}, {Jose H.} and Constantina Aggeli and Dimitrios Tousoulis and Zoghbi, {William A.} and Shah, {Dipan J.} and Little, {Stephen H.}",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s).",

year = "2020",

month = jul,

day = "30",

doi = "10.1186/s12968-020-00635-x",

language = "English (US)",

volume = "22",

pages = "55",

journal = "Journal of Cardiovascular Magnetic Resonance",

issn = "1097-6647",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance

T2 - An in vitro validation and comparison to Doppler echocardiography

AU - Maragiannis, Dimitrios

AU - Jackson, Matthew S.

AU - Autry, Kyle

AU - Flores Arredondo, Jose H.

AU - Aggeli, Constantina

AU - Tousoulis, Dimitrios

AU - Zoghbi, William A.

AU - Shah, Dipan J.

AU - Little, Stephen H.

PY - 2020/7/30

Y1 - 2020/7/30

N2 - BACKGROUND: A comprehensive non-invasive evaluation of bioprosthetic mitral valve (BMV) function can be challenging. We describe a novel method to assess BMV effective orifice area (EOA) based on phase contrast (PC) cardiovascular magnetic resonance (CMR) data. We compare the performance of this new method to Doppler and in vitro reference standards.METHODS: Four sizes of normal BMVs (27, 29, 31, 33 mm) and 4 stenotic BMVs (27 mm and 29 mm, with mild or severe leaflet obstruction) were evaluated using a CMR- compatible flow loop. BMVs were evaluated with PC-CMR and Doppler methods under flow conditions of; 70 mL, 90 mL and 110 mL/beat (n = 24). PC-EOA was calculated as PC-CMR flow volume divided by the PC- time velocity integral (TVI).RESULTS: PC-CMR measurements of the diastolic peak velocity and TVI correlated strongly with Doppler values (r = 0.99, P < 0.001 and r = 0.99, P < 0.001, respectively). Across all conditions tested, the Doppler and PC-CMR measurement of EOA (1.4 ± 0.5 vs 1.5 ± 0.7 cm 2, respectively) correlated highly (r = 0.99, P < 0.001), with a minimum bias of 0.13 cm 2, and narrow limits of agreement (- 0.2 to 0.5 cm 2). CONCLUSION: We describe a novel method to assess BMV function based on PC measures of transvalvular flow volume and velocity integration. PC-CMR methods can be used to accurately measure EOA for both normal and stenotic BMV's and may provide an important new parameter of BMV function when Doppler methods are unobtainable or unreliable.

AB - BACKGROUND: A comprehensive non-invasive evaluation of bioprosthetic mitral valve (BMV) function can be challenging. We describe a novel method to assess BMV effective orifice area (EOA) based on phase contrast (PC) cardiovascular magnetic resonance (CMR) data. We compare the performance of this new method to Doppler and in vitro reference standards.METHODS: Four sizes of normal BMVs (27, 29, 31, 33 mm) and 4 stenotic BMVs (27 mm and 29 mm, with mild or severe leaflet obstruction) were evaluated using a CMR- compatible flow loop. BMVs were evaluated with PC-CMR and Doppler methods under flow conditions of; 70 mL, 90 mL and 110 mL/beat (n = 24). PC-EOA was calculated as PC-CMR flow volume divided by the PC- time velocity integral (TVI).RESULTS: PC-CMR measurements of the diastolic peak velocity and TVI correlated strongly with Doppler values (r = 0.99, P < 0.001 and r = 0.99, P < 0.001, respectively). Across all conditions tested, the Doppler and PC-CMR measurement of EOA (1.4 ± 0.5 vs 1.5 ± 0.7 cm 2, respectively) correlated highly (r = 0.99, P < 0.001), with a minimum bias of 0.13 cm 2, and narrow limits of agreement (- 0.2 to 0.5 cm 2). CONCLUSION: We describe a novel method to assess BMV function based on PC measures of transvalvular flow volume and velocity integration. PC-CMR methods can be used to accurately measure EOA for both normal and stenotic BMV's and may provide an important new parameter of BMV function when Doppler methods are unobtainable or unreliable.

KW - Cardiovascular magnetic resonance; bioprosthetic valve

KW - Doppler echocardiography

KW - Mitral valve

KW - Prosthetic valve stenosis

KW - Predictive Value of Tests

KW - Reproducibility of Results

KW - Heart Valve Prosthesis

KW - Humans

KW - Mitral Valve/diagnostic imaging

KW - Bioprosthesis

KW - Echocardiography, Doppler, Color

KW - Prosthesis Design

KW - Feasibility Studies

KW - Magnetic Resonance Imaging

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Blood Flow Velocity

KW - Mitral Valve Stenosis/diagnostic imaging

KW - Hemodynamics

KW - Observer Variation

UR - http://www.scopus.com/inward/record.url?scp=85088850871&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85088850871&partnerID=8YFLogxK

U2 - 10.1186/s12968-020-00635-x

DO - 10.1186/s12968-020-00635-x

M3 - Article

C2 - 32727590

AN - SCOPUS:85088850871

SN - 1097-6647

VL - 22

SP - 55

JO - Journal of Cardiovascular Magnetic Resonance

JF - Journal of Cardiovascular Magnetic Resonance

IS - 1

M1 - 55

ER -

Functional assessment of bioprosthetic mitral valves by cardiovascular magnetic resonance: An in vitro validation and comparison to Doppler echocardiography

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this