Usefulness of 3-Tesla cardiac magnetic resonance imaging in the assessment of aortic stenosis severity in routine clinical practice.
BACKGROUND
Recently, 1.5-Tesla cardiac magnetic resonance imaging (CMR) was reported to provide a reliable alternative to transthoracic echocardiography (TTE) for the quantification of aortic stenosis (AS) severity. Few data are available using higher magnetic field strength MRI systems in this context.


OBJECTIVE
To evaluate the feasibility and reproducibility of the assessment of aortic valve area (AVA) using 3-Tesla CMR in routine clinical practice, and to assess concordance between TTE and CMR for the estimation of AS severity.


METHODS
Ninety-one consecutive patients (60 men; mean age 74±10years) with known AS documented by TTE were included prospectively in the study.


RESULTS
All patients underwent comprehensive TTE and CMR examination, including AVA estimation using the TTE continuity equation (0.81±0.18cm2), direct CMR planimetry (CMRp) (0.90±0.22cm2) and CMR using Hakki's formula (CMRhk), a simplified Gorlin formula (0.70±0.19cm2). Although significant agreement with TTE was found for CMRp (r=0.72) and CMRhk (r=0.66), CMRp slightly overestimated (bias=0.11±0.18cm2) and CMRhk slightly underestimated (bias=-0.11±0.17cm2) AVA compared with TTE. Inter- and intraobserver reproducibilities of CMR measurements were excellent (r=0.72 and r=0.74 for CMRp and r=0.88 and r=0.92 for peak aortic velocity, respectively).


CONCLUSIONS
3-Tesla CMR is a feasible, radiation-free, reproducible imaging modality for the estimation of severity of AS in routine practice, knowing that CMRp tends to overestimate AVA and CMRhk to underestimate AVA compared with TTE.
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco. Electronic address: flevy@ccm.mc.
Franck
F
Levy
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Laura
L
Iacuzio
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Filippo
F
Civaia
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Stephane
S
Rusek
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Carine
C
Dommerc
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Nicolas
N
Hugues
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Clara
C
Alexandrescu
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Vincent
V
Dor
Department of Cardiology, University Hospital Amiens, Inserm U-1088, Jules-Verne University of Picardie, 80000 Amiens, France.
Christophe
C
Tribouilloy
Monaco Cardiothoracic Centre, 11 bis, avenue d'Ostende, 98000 Monaco, Monaco.
Gilles
G
Dreyfus
D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index
3-Tesla cardiac magnetic resonance; Aortic stenosis; Imagerie par résonnance magnétique à 3 Tesla; Sténose aortique