Conclusion
The most relevant issues in the assessment of patients with valvular heart disease are the detection of valve lesion severity, the morphological description of heart valve and subvalvular structures, and the assessment of changes of the ventricles and the pulmonary circulation. MR imaging is an excellent, accurate and reproducible tool for the assessment of valve lesion severity and to monitor cardiac adaptation to volume and/or pressureoverload. An excellent overview of MR imaging in valvular disease is given by Schwitter 42. Due to the unique capability of MR techniques to measure flow, MR flow-velocity mapping may be particularly useful in quantification of regurgitant lesions and also in the serial assessment of changes of the heart. In the determination of stenotic lesion severity, MR imaging offers no direct advantages over echocardiography provided that echocardiographic window is adequate. Generally, 2-D echocardiography is the first method of choice in the assessment of valve lesion severity. Currently, MR techniques are generally accepted as a highly accurate technique for noninvasive measurement of blood flow, quantification of chamber dimensions, and assessment of ventricular function. With MR imaging it is possible to acquire data of lesion severity, left ventricular dimensions, and left ventricular function within 1 hour or less. In the near future, real time imaging capabilities will become routine and will shorten MR studies substantially. Consequently, there is a growing potential for application of MR imaging in patients with suspected or known valvular heart disease.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
ACC/AHA guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association. Task Force on Practice Guidelines (Committee on Management of Patients with Valvular Heart Disease). J Am Coll Cardiol 1998;32:1486–588.
Akins CW, Hilgenberg AD, Buckley MJ, et al. Mitral valve reconstruction versus replacement for degenerative or ischemic mitral regurgitation. Ann Thorac Surg 1994;58:668–75.
Ben Farhat M, Ayari M, Maatouk F, et al. Percutaneous balloon versus surgical closed and open mitral commissurotomy: seven-year follow-up results of a randomized trial. Circulation 1998;97:245–50.
Bonow RO, Lakatos E, Maron BJ, et al. Serial long-term assessment of the natural history of asymptomatic patients with chronic aortic regurgitation and normal left ventricular systolic function. Circulation 1991;84:1625–35.
Borer JS, Hochreiter C, Herrold EM, et al. Prediction of indications for valve rreplacement among a-symptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance. Circulation 1998:97:525–34.
Burwash IG, Thomas DD, Sadahir M, et al. Dependence of Gorlin formula and continuity equation valve areas on transvalvular volume flow rate in valvular aortic stenosis. Circulation 1994;89:827–35.
Chatzimavroudis GP, Oshinski JN, Pettigrew RI, et al. Quantification of mitral regurgitation with MR phase-velocity mapping using a control volume method. J Magn Reson Imaging 1998:8:577–82.
Cheitlin MD, Alpert JS, Armstrong WF, et al. ACC/AHA guidelines for the clinical application of echocardiography. Circulation 1997;95:1686–744.
Daniel WG, Hood WJ, Siart A, et al. Chronic aortic regurgitation: reassessment of the prognostic value of preoperative left ventricular end-systolic dimension and fractional shortening. Circulation 1985;71:669–80.
Dulce MC, Mostbeck GH, O’Sullivan M, et al. Severity of aortic regurgitation: interstudy reproducibility of measurements with velocity-encoded cine MR imaging. Radiology 1992;185:235–40.
Eichenberger AC, Jenni R, von Schulthess GK. Aortic valve pressure gradients in patients with aortic valve stenosis: quantification with velocity-encoded cine MR imaging. Am J Roentgenol 1993;160:971–7.
Eichenberger AC, Schwitter J, McKinnon GC, et al. Phase-contrast echo-planar MR imaging: real-time guantification of flow and velocity patterns in the thoracic vessels induced by Valsalva’s maneuver. J Magn Reson Imaging 1995;5:648–55.
Fujita N, Chazouilleres AF, Hartiala JJ, et al. Quantification of mitral regurgitation by velocityencoded cine nuclear magnetic resonance imaging. J Am Coll Cardiol 1994;23:951–8.
Gaasch WH, Carroll JD, Levine HJ, et al. Chronic aortic regurgitation: prognostic value of left ventricular end-systolic dimension and end-diastolic radius/thickness ratio. J Am Coll Cardiol 19883;1:775–82.
Globits S, Blake L, Bourne M, et al. Assessment of hemodynamic effects of angiotensinconverting enzyme inhibitor therapy in chronic aortic regurgitation by using velocity-encoded cine magnetic resonance imaging. Am Heart J 1996;131:289–93.
Gorlin R, Gorlin SG. Hydraulic formula for calculation of the area of stenotic mitral valve,other cardiac valvues and central circulatory shunts. Am Heart 1951;41:1–29.
Hammermeister KE, Sethi GK, Henderson WG, et al. A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. N Engl J Med 1993;328:1289–96.
Hegglin R, Scheu H, Rothlin M. Aortic insufficiency. Circulation 1968;38:77–92.
Honda N, Machida K, Hashimoto M, et al. Aortic regurgitation: quantitation with MR imaging velocity mapping. Radiology 1993;186:189–94.
Livanainen AM, Lindroos M, Tilvis R, et al. Natural history of aortic valve stenosis of varying severity in the elderly. Am J Cardiol 1996;78:97–101.
Kayser HW, Stoel BC, van der Wall E, et al. MR velocity mapping of tricuspid flow: correction for through-plane motion. J Magn Reson Imaging 1997;7:669–73.
Kilner PJ, Manzara CC, Mohiaddin RH, et al. Magnetic resonance jet velocity mapping in mitral and aortic valve stenosis. Circulation 1993;87:1239–48.
Klodas E, Enrique SM, Tajik AJ, et al. Aortic regurgitation complicated by extreme left ventricular dilation: long-term outcome after surgical correction. J Am Coll Cardiol 1996;27:670–7.
Kozerke S, Hasenkam JM, Pedersen EM, et al. Particle trace visualization of flow patterns downstream of a prosthetic aortic valve in patients. 7th Scientific Meeting of the ISMRM, Philadelphia 1999;3:2026.
Kozerke S, Scheidegger MB, Pederson EM, et al. Heart motion adapted cine phase-contrast flow measurements through the aortic valve. Magn Reson Med 1999;42:970–8.
Labovitz AJ, Ferrera RP, Kern MJ, et al. Quantitative evaluation of aortic insufficiency by continuous wave Doppler echocardiography. J Am Coll Cardiol 1986;8:1341–7.
Lindsay Jr. J. Beall AC Jr, DeBakey ME, Diagnosis and treatment of disease of the aorta. In: Schlant R, Alexander RW, eds. Hurst’s the heart, 9th edn. New York: McGraw-Hill, 1998:2461–82.
Lorenz CH, Walker ES, Morgan VL, et al. Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging. J Cardiovasc Magn Reson 1999;1:7–21.
Lund O. Preoperative risk evaluation and stratification of long-term survival after valve replacement for aortic stenosis. Reasons for earlier operative intervention. Circulation 1990;82:124–39.
Michel PL, ling B, Abou JS, et al. The effect of left ventricular systolic function on long-term survival in mitral and aortic regurgitation. J Heart Valve Dis 1995;4:Suppl 2:160–8.
Multicenter experience with balloon mitral commissurotomy. NHLBI Balloon Valvuloplasty Registry Participants. Circulation 1992;85:448–61.
Nadas AS, Ellison RC, Weidman WH. Report from the joint study on the Natural History of Congenital Heart Defect. Circulation 1977;56:11–187.
Nagel E, Lehmkuhl HB, Bocksch W, et al. Noninvasive diagnosis of ischemia-induced wall motion abnormalities with the use of high-dose dobutamine stress MRI: comparison with dobutamine stress echocardiography. Circulation 1999;99:763–70.
Nitenberg A, Foult JM, Antony I, et al. Coronary flow and resistance reserve in patients with chronic aortic regurgitation, angina pectoris and normal coronary arteries. J Am Coll Cardiol 1988;11:478–86.
O’Fallon WM, Weidman WJ. Long-term follow-up of congenital aortic stenosis, pulmonary stenosis, and ventricular septal defect: report from the Second Joint Study on the Natural History of Congenital Heart Defects (NHS-2). Circulation 1993;87:1–126.
Pruessmann KP, Weiger M, Scheidegger MB, et al. SENSE: Sensitivity encoding for fast MRI. Magn Reson Med 1999;42:952–62.
Rapaport E. Natural history of aortic and mitral valve disease. Am J Cardiol 1975;35:221–7.
Reimold SC, Maier SE, Fleischmann KE, et al. Dynamic nature of the aortic regurgitant orifice area during diastole in patients with chronic aortic regurgitation. Circulation 1994;89:2085–92.
Ross JJ. Afterload mismatch in aortic and mitral valve disease: implications for surgical therapy. J Am Coll Cardiol 1985;5:811–26.
Rowe JC, Bland EF, Sprague HB. The course of mitral stenosis without surgery: ten and twenty year perspectives. Ann Intern Med 1960;52:741–49.
Sakuma H, Globits S, Bourne MW, et al. Improved reproducibility in measuring LV volumes and mass using multicoil breath-hold cine MR imaging. J Magn Reson Imaging 1996;6:124–7.
Schwitter J. MR in valvular heart disease. Herz 2000; 25: 342–355.
Schwitter J, DeMarco T, Globits S, et al. Influence of felodipine on left ventricular hypertrophy and systolic function in orthotopic heart transplantant recipients: possible interaction with cyclosporine medication. J Heart Lung Transplant 1999;18:1003–13.
Schwitter J, Eberli FR, Ritter M, et al. Myocardial oxygen consumption in aortic valve disease with and without left ventricular dysfunction. Br Heart J 1992;67:161–9.
Scognamiglio R, Fasoli G, Dalla VS. Progression of myocardial dysfunction in aymptomatic patients with severe aortic insufficiency. Clin Cardiol 1986;9:151–6.
Scognamiglio R, Rahimtoola SH, Fasoli G, et al. Nifedipine in aymptomatic patients with severe aortic regurgitation and normal left ventricular function. N Engl J Med 1994;331:689–94.
Sechtem U, Pflugfelder PW, Cassidy MM, et al. Mitral or aortic regurgitation: quantification of regurgitant volumes with cine MR imaging. Radiology 1988; 167:425–30.
Sheehan FH, Mitten LS, Factors influencing accuracy in left ventricular volume determintation. Am J Cardiol 1989;64:661–4.
Schellock FG. MR imaging of metallic implants and materials: a compilation of the literature. Am J Roentgenol 1988;151:811–4.
Siemienczuk D, Greenberg B, Morris C, et al. Chronic aortic insufficiency: factors associated with progression to aortic valve replacement. Ann Intern Med 1989;110:587–92.
Sondergaard L, Hildebrandt P, Lindvig K, et al. valve area and cardiac output in aortic stenosis: quantification by magnetic resonance velocity mapping. Am Heart J 1993;126:11576–64.
Sondergaard L, Lindvig K, Hildebrand P, et al. Quantification of aortic regurgitation by magnetic resonance velocity mapping. Am Heart J 1993;125:1081–90.
Soulen RL, Budinger TF, Higgins CB. Magnetic resonance imaging of prosthetic heart valves. Radiology 1985;154:705–7.
Spann JF, Bove AA, Natarajan G, et al. Ventricular performance, pump function and compensatory mechanisms in patients with aortic stenosis. Circulation 1980;62:576–82.
Summers RM, Andraskao BJ, Feuerstein IM, et al. Evaluation of the aortic root by MRI: insights from patients with homozygous familial hypercholesterolemia. Circulation 1998;98:509–18.
Teague SM, Heinsimer JA, Anderson JL, et al. Quantification of aortic regurgitation utilizing continuous wave Doppler ultrasound. J Am Coll Cardiol 1986;8:592–9.
The clinical role of magnetic resonance in cardiovascular disease. Task Force of the European Society of Cardiology, in collaboration with the Association of European Paediatric Cardiologists. Eur Heart J 1998;19:19–39.
Tribouilloy CM, Enriquez SM, Schaff HV, et al. Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications. Circulation 1999:99:400–5.
Turina J, Hess O, Sepulcri F, et al. Spontaneous course of aortic valve disease. Eur Heart J 1987;8:471–83.
Walker PG, Oyre S, Pederson Em, et al. A new control volume method for calculating valvular regurgitation. Circulation 1995;92:579–86.
Xie GY, Berk MR, Smith MD, et al. A simplified method for determining regurgitant fraction by Doppler echocardiography in patients with aortic regurgitation. J Am Coll Cardiol 1994;24:1041–5.
Yang PC, Kerr AB, Liu AX, et al. New real-time interactive cardiac magnetic resonance imaging system complements echocardiography. J Am Coll Cardiol 1998;32:2049–56.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2004 Kluwer Academic Publishers
About this chapter
Cite this chapter
van der Wall, E. (2004). Evaluation of Valve Disease with Novel Imaging Techniques. In: Peels, C.H., Baur, L.H.B. (eds) Valve Surgery at the Turn of the Millennium. Developments in Cardiovascular Medicine, vol 251. Springer, Boston, MA. https://doi.org/10.1007/1-4020-7848-X_9
Download citation
DOI: https://doi.org/10.1007/1-4020-7848-X_9
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4020-7834-7
Online ISBN: 978-1-4020-7848-4
eBook Packages: Springer Book Archive