Abstract 15142: Disagreement Among Echocardiographic Parameters of Mitral Regurgitant Severity is Associated With Discordance Between MRI and Echocardiography
Introduction: Echocardiographic (Echo) parameters to determine the severity of mitral regurgitation (MR) may disagree. To this date, no study has determined the rate of disagreement of Echo parameters in patients with MR. Furthermore, no study has determined whether disagreement among Echo parameters is associated with discordance between Echo and MRI in assessing the severity of MR.
Hypothesis: Disagreement of Echo parameters will be associated with discordance between Echo and MRI assessment of MR.
Methods: This study included 115 patients (62 ± 14yrs, male 55%) enrolled in a prospective multicenter study of patients with MR who underwent Echo and MRI. Severity of MR by MRI was determined by regurgitant volume (mild <30ml, moderate 30-59ml, severe ≥60ml). Severity of MR by Echo was determined using the American Society of Echocardiography (ASE) integrated method. Echo and MRI discordance was determined by the difference in grade of MR. Based on the ASE guidelines, Echo parameters (EROA, vena contracta, regurgitant volume, jet/LA area ratio, LV EDD, LA volume index, peak E wave, pulmonary vein reversal, and the presence of a flail) were divided dichotomously as reflecting either severe or not severe MR. For each patient the percentage of Echo parameters in agreement was calculated with higher numbers associated with better agreement.
Results: All nine Echo parameters agreed in 6 (5%) patients. There was agreement of 78-89% of parameters in 54 (47%) patients and 56-67% in 55 (48%) patients. There was a significantly lower agreement among Echo parameters in patients in whom there was a 2 grade difference between Echo and MRI compared to patients in whom Echo and MRI agreed (figure).
Conclusions: There was significant disagreement among Echo parameters in almost half the patients with complete agreement among Echo parameters in only 5% of patients. Disagreement among Echo parameters was associated with discordance between Echo and MRI in the quantification of MR.
Author Disclosures: S. Uretsky: None. L. Marcoff: None. K. Koulogiannis: None. L. Aldaia: None. E. Argulian: None. M. Rosenthal: None. L. Gillam: None. S. Wolff: None.
- © 2016 by American Heart Association, Inc.