Skip to main content
SpringerLink
Log in

Complimentary Role of CT/MRI in the Assessment of Aortic Stenosis

  • Chapter
Aortic Stenosis

Abstract

Cardiac magnetic resonance imaging (CMR) and cardiac computed tomography (CT) have specific advantages and disadvantages that supplement, but do not supplant echocardiography as the major imaging modality used for management of patients with aortic stenosis (AS). In general, CMR provides more complete physiologic information than CT, but CT angiography has broader general applicability, as it is now frequently used for coronary angiography and is a main tool in pre-procedural planning and valve sizing for transcutaneous aortic valve replacement (TAVR).

 One major impediment to more pervasive use of these tests is the lack available equipment and expertise in many centers. In addition, there are application-specific intrinsic limitations, which we will delineate, that allow echocardiography to remain the mainstay of diagnosis of severe AS. However, specific advantages may make these techniques uniquely advantageous in select patients with inconclusive diagnosis. In this chapter we will review the incremental role of cardiac MRI and CTA in patients with aortic stenosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kramer CM, Barkhausen J, Flamm SD, Kim RJ, Nagel E. Standardized cardiovascular magnetic resonance (CMR) protocols 2013 update. J Cardiovasc Magn Reson. 2013;15:91.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  2. Cawley PJ, Maki JH, Otto CM. Cardiovascular magnetic resonance imaging for valvular heart disease: technique and validation. Circulation. 2009;119:468–78.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  3. Pibarot P, Larose É, Dumesnil J. Imaging of valvular heart disease. Can J Cardiol. 2013;29(3):337–49.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  4. Hendel RC, Patel MR, Kramer CM, Poon M, et al. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48(7):1475–97.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  5. Pennel DJ, Sechtem UP, Higgins CB, et al. Clinical indications for cardiovascular magnetic resonance (CMR): consensus panel report. J Cardiovasc Magn Reson. 2004;6:727–65.

    ArticleΒ  Google ScholarΒ 

  6. Myerson SG. Heart valve disease: investigation by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2012;14:7.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  7. Longmore DB, Klipstein RH, Underwood SR, Firmin DN, Hounsfield GN, Watanabe M, Bland C, Fox K, Poole-Wilson PA, Rees RS. Dimensional accuracy of magnetic resonance in studies of the heart. Lancet. 1985;1:1360–2.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  8. Rehr RB, Malloy CR, Filipchuk NG, Peshock RM. Left ventricular volumes measured by MR imaging. Radiology. 1985;156:717–9.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  9. Sechtem U, Pflugfelder PW, Gould RG, Cassidy MM, Higgins CB. Measurement of right and left ventricular volumes in healthy individuals with cine MR imaging. Radiology. 1987;163:697–702.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  10. Jauhiainen T, Jarvinen VM, Hekali PE, Poutanen VP, Penttila A, Kupari M. MR gradient echo volumetric analysis of human cardiac casts: focus on the right ventricle. J Comput Assist Tomogr. 1998;22:899–903.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  11. Eichenberger AC, Jenni R, von Schulthess GK. Aortic valve pressure gradients in patients with aortic valve stenosis: quantification with velocity-encoded cine MR imaging. AJR Am J Roentgenol. 1993;160:971–7.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  12. Niederberger J, Schima H, Maurer G, Baumgartner H. Importance of pressure recovery for the assessment of aortic stenosis by doppler ultrasound: role of aortic size, aortic valve area, and direction of the stenotic jet in vitro. Circulation. 1996;94:1934–40.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  13. Richards KE, Deserranno D, Donal E, Greenberg NL, Thomas JD, Garcia MJ. Influence of structural geometry on the severity of bicuspid aortic stenosis. Am J Physiol Heart Circ Physiol. 2004;287(3):H1410–6.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  14. Joziasse IC, Vink A, Cramer MJ, van Oosterhout MF, et al. Bicuspid stenotic aortic valves: clinical characteristics and morphological assessment using MRI and echocardiography. Neth Heart J. 2011;19(3):119–25.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  15. Kari FA, Fazel SS, Mitchell RS, Fishbein MP, Miller DC. Bicuspid aortic valve configuration and aortopathy pattern might represent different pathophysiologic substrates. J Thorac Cardiovasc Surg. 2012;144(2):516–7.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  16. Donal E, Novaro GM, Deserrano D, Popovic ZB, Greenberg NL, Richards KE, Thomas JD, Garcia MJ. Planimetric assessment of anatomic valve area overestimates effective orifice area in bicuspid aortic stenosis. J Am Soc Echocardiogr. 2005;18:1392–8.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  17. Dweck MR, Joshi S, Murigu T, Alpendurada F, Jabbour A, Melina G, Banya W, Gulati A, Roussin I, Raza S, Prasad NA, Wage R, Quarto C, Angeloni E, Refice S, Sheppard M, Cook SA, Kilner PJ, Pennell DJ, Newby DE, Mohiaddin RH, Pepper J, Prasad SK. Midwall fibrosis is an independent predictor of mortality in patients with aortic stenosis. J Am Coll Cardiol. 2011;58(12):1271–9.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  18. Weidemann F, Herrmann S, Stork S, Niemann M, Frantz S, Lange V, Beer M, Gattenlohner S, Voelker W, Ertl G, Strotmann JM. Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis. Circulation. 2009;120(7):577–84.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  19. Nigri M, Azevedo CF, Rochitte CE, Schraibman V, Tarasoutchi F, Pommerantzeff PM, Brandão CM, Sampaio RO, Parga JR, Avila LF, Spina GS, Grinberg M. Contrast-enhanced magnetic resonance imaging identifies focal regions of intramyocardial fibrosis in patients with severe aortic valve disease: correlation with quantitative histopathology. Am Heart J. 2009;157(2):361–8.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  20. Habets J, Tanis W, van Herwerden LA, van den Brink RB, Mali WP, de Mol BA, Chamuleau SA, Budde RP. Cardiac computed tomography angiography results in diagnostic and therapeutic change in prosthetic heart valve endocarditis. Int J Cardiovasc Imaging. 2014;30(2):377–87.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  21. Piers LH, Dikkers R, Tio RA, van den Berg MP, Willems TP, Zijlstra F, Oudkerk M. A comparison of echocardiographic and electron beam computed tomographic assessment of aortic valve area in patients with valvular aortic stenosis. Int J Cardiovasc Imaging. 2007;23(6):781–8.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  22. Westermann Y, Geigenmüller A, Elgeti T, Wagner M, Dushe S, Borges AC, Dohmen PM, Hein PA, Lembcke A. Planimetry of the aortic valve orifice area: comparison of multislice spiral computed tomography and magnetic resonance imaging. Eur J Radiol. 2011;77(3):426–35.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  23. Chun EJ, Choi SI, Lim C, Park KH, Chang HJ, Choi DJ, Kim DH, Lee W, Park JH. Aortic stenosis: evaluation with multidetector CT angiography and MR imaging. Korean J Radiol. 2008;9(5):439–48.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  24. Utsunomiya H, Yamamoto H, Kitagawa T, Kunita E, Urabe Y, Tsushiuma H, Hidaka T, Awai K, Kihara Y. Incremental prognostic value of cardiac computed tomography in asymptomatic aortic stenosis: significance of aortic valve calcium score. Int J Cardiol. 2013;168(6):5205–11.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  25. Pflederer T, Jakstat J, Marwan M, Schepis T, Bachmann S, Kuettner A, Anders K, Lell M, Muschiol G, Ropers D, Daniel WG, Achenbach S. Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison. Eur Radiol. 2010;20(5):1197–206.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  26. Greupner J, Zimmermann E, Grohmann A, et al. Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2-and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard. J Am Coll Cardiol. 2012;59(21):1897–907.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  27. Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 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 (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(13):e1–142.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  28. Kupfahl C, Honold M, Meinhardt G, Vogelsberg H, Wagner A, Mahrholdt H, Sechtem U. Evaluation of aortic stenosis by cardiovascular magnetic resonance imaging: comparison with established routine clinical techniques. Heart. 2004;90:893–901.

    ArticleΒ  CASΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  29. Van Pul C, de Jong NMCM, van Beek LM, Pasmans HLM, Wijn PFF, Visser RF. MRI for diagnosing aortic valve stenosis: a comparison study of MRI and ultrasound. Neth Heart J. 2005;13:11.

    Google ScholarΒ 

  30. Garcia J, Kadem L, Larose E, Clavel MA, Pibarot P. Comparison between cardiovascular magnetic resonance and transthoracic Doppler echocardiography for the estimation of effective orifice area in aortic stenosis. J Cardiovasc Magn Reson. 2011;13:25.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  31. Friedrich MG, Schulz-Menger J, et al. Quantification of valvular aortic stenosis by magnetic resonance imaging. Am Heart J. 2002;144(2):329–34.

    Google ScholarΒ 

  32. John AS, Dill T, Brandt RR, Rau M, Ricken W, Bachmann G, Hamm CW. Magnetic resonance to assess the aortic valve area in aortic stenosis: how does it compare to current diagnostic standards? J Am Coll Cardiol. 2003;42(3):519–26.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  33. Debl K, Djavidani B, Seitz J, Nitz W, Schmid FX, Muders F, Buchner S, Feuerbach S, Riegger G, Luchner A. Planimetry of aortic valve area in aortic stenosis by magnetic resonance imaging. Invest Radiol. 2005;40(10):631–6.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  34. Malyar NM, Schlosser T, Barkhausen J, Gutersohn A, Buck T, Bartel T, Erbel R. Assessment of aortic valve area in aortic stenosis using cardiac magnetic resonance tomography: comparison with echocardiography. Cardiology. 2008;109(2):126–34.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  35. Krishnam MS, Tomasian A, Iv M, Ruehm SG, Saleh R, Panknin C, Goldin JG. Left ventricular ejection fraction using 64-slice CT coronary angiography and new evaluation software: initial experience. Br J Radiol. 2008;81(966):450–5.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  36. de Filippi CR, Willett DL, Brickner ME. Usefulness of dobutamine echocardiography in distinguishing severe from nonsevere valvular aortic stenosis in patients with depressed left ventricular function and low transvalvular gradients. Am J Cardiol. 1995;75:191–4.

    ArticleΒ  Google ScholarΒ 

  37. Lange RA, Hillis LD. Dobutamine stress echocardiography in patients with low-gradient aortic stenosis. Circulation. 2006;113(14):1718–20.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  38. Pereira JJ, Lauer MS, Bashir M, Afridi I, Blackstone EH, Stewart WJ, McCarthy PM, Thomas JD, Asher CR. Survival after aortic valve replacement for severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction. J Am Coll Cardiol. 2002;39(8):1356–63.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  39. Nishimura RA, Grantham JA, Connolly HM, Schaff HV, Higano ST, Holmes Jr DR. Low-output, low-gradient aortic stenosis in patients with depressed left ventricular systolic function: the clinical utility of the dobutamine challenge in the catheterization laboratory. Circulation. 2002;106(7):809–13.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  40. Blais C, Burwash IG, Mundigler G, Dumesnil JG, Loho N, Rader F, Baumgartner H, Beanlands RS, Chayer B, Kadem L, Garcia D, Durand LG, Pibarot P. Projected valve area at normal flow rate improves the assessment of stenosis severity in patients with low-flow, low-gradient aortic stenosis: the multicenter TOPAS (Truly or Pseudo-Severe Aortic Stenosis) study. Circulation. 2006;113(5):711–21.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  41. Tribouilloy C, Levy F, Rusinaru D, Gueret P, Petit-Eisenmann H, Baleynaud S, Jobic Y, Adams C, Lelong B, Pasquet A, Chauvel C, Metz D, Quere JP, Monin JL. Outcome after aortic valve replacement for low-flow/low-gradient aortic stenosis without contractile reserve on dobutamine stress echocardiography. J Am Coll Cardiol. 2009;53(20):1865–73.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  42. Levy F, Laurent M, Monin JL, Maillet JM, Pasquet A, Le Tourneau T, Petit-Eisenmann H, Gori M, Jobic Y, Bauer F, Chauvel C, Leguerrier A, Tribouilloy C. Aortic valve replacement for low-flow/low-gradient aortic stenosis operative risk stratification and long-term outcome: a European multicenter study. J Am Coll Cardiol. 2008;51(15):1466–72.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  43. Ozkan A, Hachamovitch R, Kapadia SR, Tuzcu EM, Marwick TH. Impact of aortic valve replacement on outcome of symptomatic patients with severe aortic stenosis with low gradient and preserved left ventricular ejection fraction. Circulation. 2013;128(6):622–31.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  44. Connolly HM, Oh JK, Orszulak TA, Osborn SL, Roger VL, Hodge DO, Bailey KR, Seward JB, Tajik AJ. Aortic valve replacement for aortic stenosis with severe left ventricular dysfunction. Prognostic indicators. Circulation. 1997;95(10):2395–400.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  45. Barone-Rochette G, Pierard S, Seldrum S, de Meester Ravenstein C, Melchior J, Maes F, Pouleur AC, Vancraeynest D, Pasquet A, Vanoverschelde JL, Gerber BL. Aortic valve area, stroke volume, left ventricular hypertrophy, remodeling, and fibrosis in aortic stenosis assessed by cardiac magnetic resonance imaging: comparison between high and low gradient and normal and low flow aortic stenosis. Circ Cardiovasc Imaging. 2013;6(6):1009–17.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  46. Cramariuc D, Cioffi G, Rieck AE, Devereux RB, Staal EM, Ray S, Wachtell K, Gerdts E. Low-flow aortic stenosis in asymptomatic patients: valvular-arterial impedance and systolic function from the SEAS substudy. JACC Cardiovasc Imaging. 2009;2(4):390–9.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  47. Lancellotti P, Donal E, Magne J, Moonen M, O’Connor K, Daubert JC, Pierard LA. Risk stratification in asymptomatic moderate to severe aortic stenosis: the importance of the valvular, arterial and ventricular interplay. Heart. 2010;96(17):1364–71.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  48. Hachicha Z, Dumesnil JG, Pibarot P. Usefulness of the valvuloarterial impedance to predict adverse outcome in asymptomatic aortic stenosis. J Am Coll Cardiol. 2009;54(11):1003–11.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  49. Pibarot P, Dumesnil JG. Improving assessment of aortic stenosis. J Am Coll Cardiol. 2012;60(3):169–80.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  50. Thomas B, Freitas A, Ferreira R, Tavares NJ. The complementary role of cardiac magnetic resonance imaging in the evaluation of patients with aortic stenosis. Rev Port Cardiol. 2005;24(9):1117–21.

    PubMedΒ  Google ScholarΒ 

  51. Dimitriou P, Kahari A, Emilsson K, Thunberg P. Cardiovascular magnetic resonance imaging and transthoracic echocardiography in the assessment of stenotic aortic valve area: a comparative study. Acta Radiol. 2012;53(9):995–1003.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  52. Michelena HI, Margaryan E, Miller FA, Eleid M, Maalouf J, Suri R, Messika-Zeitoun D, Pellikka PA, Enriquez-Sarano M. Inconsistent echocardiographic grading of aortic stenosis: is the left ventricular outflow tract important? Heart. 2013;99(13):921–31.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  53. Garcia D, Pibarot P, Dumesnil JG, Sakr F, Durand LG. Assessment of aortic valve stenosis severity: a new index based on the energy loss concept. Circulation. 2000;101(7):765–71.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  54. Bahlmann E, Cramariuc D, Gerdts E, Gohlke-Baerwolf C, Nienaber CA, Eriksen E, Wachtell K, Chambers J, Kuck KH, Ray S. Impact of pressure recovery on echocardiographic assessment of asymptomatic aortic stenosis: a SEAS substudy. JACC Cardiovasc Imaging. 2010;3(6):555–62.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  55. Bahlmann E, Gerdts E, Cramariuc D, Gohlke-Baerwolf C, Nienaber CA, Wachtell K, Seifert R, Chambers JB, Kuck KH, Ray S. Prognostic value of energy loss index in asymptomatic aortic stenosis. Circulation. 2013;127(10):1149–56.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  56. Van der Linde D, Rossi A, Yap SC, McGhie JS, van den Bosch AE, Kirschbaum SW, Russo B, van Dijk AP, Moelker A, Krestin GP, van Geuns RJ, Roos-Hesselink JW. Ascending aortic diameters in congenital aortic stenosis: cardiac magnetic resonance versus transthoracic echocardiography. Echocardiography. 2013;30(5):497–504.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  57. Leong DP, Joseph MX, Selvanayagam JB. The evolving role of multimodality imaging in valvular heart disease. Heart. 2014;100(4):336–46.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  58. Abbas AE, Franey LM, Goldstein J, Lester S. Aortic valve stenosis: to the gradient and beyond-the mismatch between area and gradient severity. J Interv Cardiol. 2013;26(2):183–94.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  59. Masci PG, Dymarkowski S, Bogaert J. Valvular heart disease: what does cardiovascular MRI add? Eur Radiol. 2008;18(2):197–208.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  60. Puymirat E, Chassaing S, Trinquart L, Barbey C, Chaudeurge A, Bar O, Blanchard D. Hakki’s formula for measurement of aortic valve area by magnetic resonance imaging. Am J Cardiol. 2010;106(2):249–54.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  61. Haghi D, Kaden JJ, Suselbeck T, Fluechter S, Breithardt OA, Poerner T, Kalmar G, Borggrefe M, Papavassiliu T. Validation of the peak to mean pressure decrease ratio as a new method of assessing aortic stenosis using the Gorlin formula and the cardiovascular magnetic resonance-based hybrid method. Echocardiography. 2007;24(4):335–9.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  62. Gorlin R, Gorlin SG. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts. Am Heart J. 1951;41:1–29.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  63. Hakki AH, Iskandrian AS, Bemis CE, Kimbiris D, Mintz GS, Segal BL, Brice C. A simplified valve formula for the calculation of stenotic cardiac valve areas. Circulation. 1981;63:1050–5.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  64. Cueff C, Serfaty JM, Cimadevilla C, Laissy JP, Himbert D, Tubach F, Duval X, Iung B, Enriquez-Sarano M, Vahanian A, Messika-Zeitoun D. Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction. Heart. 2011;97(9):721–6.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  65. Utsunomiya H, Yamamoto H, Kunita E, Kitagawa T, Ohashi N, Oka T, Yamazato R, Horiguchi J, Kihara Y. Combined presence of aortic valve calcification and mitral annular calcification as a marker of the extent and vulnerable characteristics of coronary artery plaque assessed by 64-multidetector computed tomography. Atherosclerosis. 2010;213(1):166–72.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  66. Warnes CA. Bicuspid aortic valve and coarctation: two villains part of a diffuse problem. Heart. 2003;89:965–6.

    ArticleΒ  CASΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  67. Dyverfeldt P, Hope MD, Tseng EE, Saloner D. Magnetic resonance measurement of turbulent kinetic energy for the estimation of irreversible pressure loss in aortic stenosis. JACC Cardiovasc Imaging. 2013;6(1):64–71.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  68. Biederman RW, Doyle M, Yamrozik J, Williams RB, Rathi VK, Vido D, Caruppannan K, Osman N, Bress V, Rayarao G, Biederman CM, Mankad S, Magovern JA, Reichek N. Physiologic compensation is supranormal in compensated aortic stenosis: does it return to normal after aortic valve replacement or is it blunted by coexistent coronary artery disease? An intramyocardial magnetic resonance imaging study. Circulation. 2005;112(9 Suppl):I429–36.

    PubMedΒ  Google ScholarΒ 

  69. Biederman RW, Magovern JA, Grant SB, Williams RB, Yamrozik JA, Vido DA, Rathi VK, Rayarao G, Caruppannan K, Doyle M. LV reverse remodeling imparted by aortic valve replacement for severe aortic stenosis; is it durable? A cardiovascular MRI study sponsored by the American Heart Association. J Cardiothorac Surg. 2011;6:53.

    ArticleΒ  PubMed CentralΒ  PubMedΒ  Google ScholarΒ 

  70. Hoffman JIE. The natural and unnatural history of congenital heart disease. Chichester/Hoboken: Wiley-Blackwell; 2009.

    BookΒ  Google ScholarΒ 

  71. Aboulhosn J, Child JS. Left ventricular outflow obstruction: subaortic stenosis, bicuspid aortic valve, supravalvar aortic stenosis, and coarctation of the aorta. Circulation. 2006;114:2412–22.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  72. van der Linde D, Takkenberg JJ, Rizopoulos D, et al. Natural history of discrete subaortic stenosis is adults: a multicenter study. Eur Heart J. 2013;34(21):1548–56.

    ArticleΒ  PubMedΒ  Google ScholarΒ 

  73. Leichter DA, Sullivan I, Gersony WN. Acquired discrete subvalvular aortic stenosis: natural history and hemodynamics. J Am Coll Cardiol. 1989;14:1539–44.

    ArticleΒ  CASΒ  PubMedΒ  Google ScholarΒ 

  74. Trinchero R, Demarie D, Orzan F, Presbitero P, Defilippi G, Brusca A, Ottino G, Morea M. Fixed subaortic stenosis: natural history of patients with mild obstruction and follow-up of operated patients. G Ital Cardiol. 1988;18:738–44.

    CASΒ  PubMedΒ  Google ScholarΒ 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Beaumont Health, Oakland University/William Beaumont School of Medicine, Royal Oak, MI, USA

    A. Neil Bilolikar MDΒ &Β Gilbert L. Raff MD, FACC, FSCCT

Authors
  1. A. Neil Bilolikar MD
    View author publications

    You can also search for this author in PubMedΒ Google Scholar

  2. Gilbert L. Raff MD, FACC, FSCCT
    View author publications

    You can also search for this author in PubMedΒ Google Scholar

Corresponding author

Correspondence to A. Neil Bilolikar MD .

Editor information

Editors and Affiliations

  1. Interventional Cardiology Research, Beaumont Health System, Royal Oak, Michigan, USA

    Amr E. Abbas

Rights and permissions

Reprints and permissions

Copyright information

Β© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Bilolikar, A.N., Raff, G.L. (2015). Complimentary Role of CT/MRI in the Assessment of Aortic Stenosis. In: Abbas, A. (eds) Aortic Stenosis. Springer, London. https://doi.org/10.1007/978-1-4471-5242-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5242-2_7

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5241-5

  • Online ISBN: 978-1-4471-5242-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation