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The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI

There remains a debate whether the ventricular volume within prolapsing mitral valve (MV) leaflets should be included in the left ventricular (LV) end-systolic volume, and therefore factored in LV stroke volume (SV), in cardiac magnetic resonance (CMR) assessments. This study aims to compare LV volu...

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Autores principales: Li, Rui, Assadi, Hosamadin, Matthews, Gareth, Mehmood, Zia, Grafton-Clarke, Ciaran, Kasmai, Bahman, Hewson, David, Greenwood, Richard, Spohr, Hilmar, Zhong, Liang, Zhao, Xiaodan, Sawh, Chris, Duehmke, Rudolf, Vassiliou, Vassilios S., Nelthorpe, Faye, Ashman, David, Curtin, John, Yashoda, Gurung-Koney, Van der Geest, Rob J., Alabed, Samer, Swift, Andrew J., Hughes, Marina, Garg, Pankaj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9945133/
https://www.ncbi.nlm.nih.gov/pubmed/36810480
http://dx.doi.org/10.3390/medsci11010013
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author Li, Rui
Assadi, Hosamadin
Matthews, Gareth
Mehmood, Zia
Grafton-Clarke, Ciaran
Kasmai, Bahman
Hewson, David
Greenwood, Richard
Spohr, Hilmar
Zhong, Liang
Zhao, Xiaodan
Sawh, Chris
Duehmke, Rudolf
Vassiliou, Vassilios S.
Nelthorpe, Faye
Ashman, David
Curtin, John
Yashoda, Gurung-Koney
Van der Geest, Rob J.
Alabed, Samer
Swift, Andrew J.
Hughes, Marina
Garg, Pankaj
author_facet Li, Rui
Assadi, Hosamadin
Matthews, Gareth
Mehmood, Zia
Grafton-Clarke, Ciaran
Kasmai, Bahman
Hewson, David
Greenwood, Richard
Spohr, Hilmar
Zhong, Liang
Zhao, Xiaodan
Sawh, Chris
Duehmke, Rudolf
Vassiliou, Vassilios S.
Nelthorpe, Faye
Ashman, David
Curtin, John
Yashoda, Gurung-Koney
Van der Geest, Rob J.
Alabed, Samer
Swift, Andrew J.
Hughes, Marina
Garg, Pankaj
author_sort Li, Rui
collection PubMed
description There remains a debate whether the ventricular volume within prolapsing mitral valve (MV) leaflets should be included in the left ventricular (LV) end-systolic volume, and therefore factored in LV stroke volume (SV), in cardiac magnetic resonance (CMR) assessments. This study aims to compare LV volumes during end-systolic phases, with and without the inclusion of the volume of blood on the left atrial aspect of the atrioventricular groove but still within the MV prolapsing leaflets, against the reference LV SV by four-dimensional flow (4DF). A total of 15 patients with MV prolapse (MVP) were retrospectively enrolled in this study. We compared LV SV with (LV SV(MVP)) and without (LV SV(standard)) MVP left ventricular doming volume, using 4D flow (LV SV(4DF)) as the reference value. Significant differences were observed when comparing LV SV(standard) and LV SV(MVP) (p < 0.001), and between LV SV(standard) and LV SV(4DF) (p = 0.02). The Intraclass Correlation Coefficient (ICC) test demonstrated good repeatability between LV SV(MVP) and LV SV(4DF) (ICC = 0.86, p < 0.001) but only moderate repeatability between LV SV(standard) and LV SV(4DF) (ICC = 0.75, p < 0.01). Calculating LV SV by including the MVP left ventricular doming volume has a higher consistency with LV SV derived from the 4DF assessment. In conclusion, LV SV short-axis cine assessment incorporating MVP dooming volume can significantly improve the precision of LV SV assessment compared to the reference 4DF method. Hence, in cases with bi-leaflet MVP, we recommend factoring in MVP dooming into the left ventricular end-systolic volume to improve the accuracy and precision of quantifying mitral regurgitation.
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spelling pubmed-99451332023-02-23 The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI Li, Rui Assadi, Hosamadin Matthews, Gareth Mehmood, Zia Grafton-Clarke, Ciaran Kasmai, Bahman Hewson, David Greenwood, Richard Spohr, Hilmar Zhong, Liang Zhao, Xiaodan Sawh, Chris Duehmke, Rudolf Vassiliou, Vassilios S. Nelthorpe, Faye Ashman, David Curtin, John Yashoda, Gurung-Koney Van der Geest, Rob J. Alabed, Samer Swift, Andrew J. Hughes, Marina Garg, Pankaj Med Sci (Basel) Article There remains a debate whether the ventricular volume within prolapsing mitral valve (MV) leaflets should be included in the left ventricular (LV) end-systolic volume, and therefore factored in LV stroke volume (SV), in cardiac magnetic resonance (CMR) assessments. This study aims to compare LV volumes during end-systolic phases, with and without the inclusion of the volume of blood on the left atrial aspect of the atrioventricular groove but still within the MV prolapsing leaflets, against the reference LV SV by four-dimensional flow (4DF). A total of 15 patients with MV prolapse (MVP) were retrospectively enrolled in this study. We compared LV SV with (LV SV(MVP)) and without (LV SV(standard)) MVP left ventricular doming volume, using 4D flow (LV SV(4DF)) as the reference value. Significant differences were observed when comparing LV SV(standard) and LV SV(MVP) (p < 0.001), and between LV SV(standard) and LV SV(4DF) (p = 0.02). The Intraclass Correlation Coefficient (ICC) test demonstrated good repeatability between LV SV(MVP) and LV SV(4DF) (ICC = 0.86, p < 0.001) but only moderate repeatability between LV SV(standard) and LV SV(4DF) (ICC = 0.75, p < 0.01). Calculating LV SV by including the MVP left ventricular doming volume has a higher consistency with LV SV derived from the 4DF assessment. In conclusion, LV SV short-axis cine assessment incorporating MVP dooming volume can significantly improve the precision of LV SV assessment compared to the reference 4DF method. Hence, in cases with bi-leaflet MVP, we recommend factoring in MVP dooming into the left ventricular end-systolic volume to improve the accuracy and precision of quantifying mitral regurgitation. MDPI 2023-01-24 /pmc/articles/PMC9945133/ /pubmed/36810480 http://dx.doi.org/10.3390/medsci11010013 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, Rui
Assadi, Hosamadin
Matthews, Gareth
Mehmood, Zia
Grafton-Clarke, Ciaran
Kasmai, Bahman
Hewson, David
Greenwood, Richard
Spohr, Hilmar
Zhong, Liang
Zhao, Xiaodan
Sawh, Chris
Duehmke, Rudolf
Vassiliou, Vassilios S.
Nelthorpe, Faye
Ashman, David
Curtin, John
Yashoda, Gurung-Koney
Van der Geest, Rob J.
Alabed, Samer
Swift, Andrew J.
Hughes, Marina
Garg, Pankaj
The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI
title The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI
title_full The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI
title_fullStr The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI
title_full_unstemmed The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI
title_short The Importance of Mitral Valve Prolapse Doming Volume in the Assessment of Left Ventricular Stroke Volume with Cardiac MRI
title_sort importance of mitral valve prolapse doming volume in the assessment of left ventricular stroke volume with cardiac mri
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9945133/
https://www.ncbi.nlm.nih.gov/pubmed/36810480
http://dx.doi.org/10.3390/medsci11010013
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