PMID- 33745455
OWN - NLM
STAT- MEDLINE
DCOM- 20210816
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 23
IP  - 1
DP  - 2021 Mar 22
TI  - Cardiovascular magnetic resonance and transesophageal echocardiography in 
      patients with prosthetic valve paravalvular leaks: towards an accurate 
      quantification and stratification.
PG  - 31
LID - 10.1186/s12968-021-00722-7 [doi]
LID - 31
AB  - BACKGROUND: Objective assessment of prosthetic paravalvular leak (PVL) is complex 
      and challenging even in transesophageal echocardiography (TEE). Our aim was to 
      assess the value of cardiovascular magnetic resonance (CMR) in quantifying PVL in 
      aortic (AVR) or mitral valve (MVR) replacement. METHODS: Thirty-one patients 
      (62 +/- 15.1 years, 63% males) with a preliminary diagnosis of significant PVL 
      (AVR, n-23; MVR, n = 8) were recruited. The TEE PVL grading was based on the 
      semi-quantitative (SQ) TEE according to the VARC II PVL classification (%PVL: 
      mild < 10%; moderate 10%-30%; severe > 30%). Non-contrast CMR studies were 
      acquired at 1.5 T with a quantitative approach (phase-contrast velocity encoded 
      imaging). The CMR PVL severity was classified according to regurgitant fraction 
      (RF: (1) mild </= 20%, (2) moderate 21%-39%, or (3) severe >/= 40%). RESULTS: All 
      patients revealed symptoms of heart failure (71%: New York Heart Association 
      [NYHA] II; 91%: N-terminal pro-B-type natriuretic peptide 
      [NT-proBNP] > 150 pg/ml) and typical cardiovascular disease risk factors. The 
      SQ-TEE results revealed several categories: (1) mild (n = 5; 16%), (2) moderate 
      (n = 21; 67%), and (3) severe (n = 5; 16%) PVL. However, CMR PVL RF reclassified 
      the severity of PVL: (1) mild to moderate (in 80%), (2) moderate to severe (in 
      47%), and (3) severe to moderate (in 40%). The receiver operating characteristic 
      analysis showed that SQ-TEE and CMR PVL-vol and -RF predicted the upper tertile 
      of NT-proBNP (> 2000 pg/ml) with the best sensitivity for CMR parameters. 
      CONCLUSION: The SQ-TEE showed moderate agreement with CMR and underestimated a 
      considerable number of AVR or MVR-PVL.
FAU - Haberka, Maciej
AU  - Haberka M
AUID- ORCID: 0000-0002-2296-8827
AD  - Department of Cardiology, Medical University of Silesia, Ziolowa 45/47, 40-635, 
      Katowice, Poland. mhaberka@op.pl.
FAU - Malczewska, Magdalena
AU  - Malczewska M
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
FAU - Pysz, Piotr
AU  - Pysz P
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
AD  - Department of Cardiac Rehabilitation, Treatment and Rehabilitation Center, 
      Long-Term Care Hospital, Jaworze, Poland.
FAU - Kozlowski, Michal
AU  - Kozlowski M
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
FAU - Wojakowski, Wojciech
AU  - Wojakowski W
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
FAU - Smolka, Grzegorz
AU  - Smolka G
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210322
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
SB  - IM
MH  - Aged
MH  - Aortic Valve/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Valve Insufficiency/*diagnostic imaging/etiology/physiopathology
MH  - *Echocardiography, Transesophageal
MH  - Female
MH  - Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*adverse effects/instrumentation
MH  - Hemodynamics
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/diagnostic imaging/physiopathology/*surgery
MH  - Mitral Valve Insufficiency/*diagnostic imaging/etiology/physiopathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Severity of Illness Index
PMC - PMC7983376
OTO - NOTNLM
OT  - Cardiovascular magnetic resonance
OT  - Echocardiography
OT  - Paravalvular leak
OT  - Valve prosthesis
COIS- None.
EDAT- 2021/03/23 06:00
MHDA- 2021/08/17 06:00
PMCR- 2021/03/22
CRDT- 2021/03/22 05:41
PHST- 2020/08/18 00:00 [received]
PHST- 2021/02/01 00:00 [accepted]
PHST- 2021/03/22 05:41 [entrez]
PHST- 2021/03/23 06:00 [pubmed]
PHST- 2021/08/17 06:00 [medline]
PHST- 2021/03/22 00:00 [pmc-release]
AID - S1097-6647(23)00372-1 [pii]
AID - 722 [pii]
AID - 10.1186/s12968-021-00722-7 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2021 Mar 22;23(1):31. doi: 10.1186/s12968-021-00722-7.