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Assessment of the Severity of Aortic Regurgitation by Noninvasive Imaging

Non-invasive MMI for AR

  • Echocardiography (JM Gardin and AH Waller, Section Editors)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

The role of multimodality imaging in the evaluation of patients with aortic regurgitation is summarized in this review.

Recent Findings

The etiology (mechanism) of the aortic regurgitation and the severity of aortic regurgitation and hemodynamic consequences are key in the decision making of patients with severe aortic regurgitation. While echocardiography remains as the leading technique to assess all these parameters, other imaging techniques have become essential for the accurate assessment of aortic regurgitation severity and the timing of aortic intervention. The anatomic suitability of transcatheter aortic valve implantation in inoperable patients with severe aortic regurgitation is usually assessed with computed tomography.

Summary

Aortic regurgitation is a prevalent disease with various pathophysiological mechanisms that need a personalized treatment. The evaluation of the mechanism and severity of aortic regurgitation can be initially performed with echocardiography. Three-dimensional techniques, including echocardiography, have become very relevant for accurate assessment of the regurgitation severity and its hemodynamic consequences. Assessment of myocardial tissue characteristics with cardiac magnetic resonance is key in the risk stratification of patients and in the timing of aortic intervention. Computed tomography is important in the assessment of aortic dimensions and selection of patients for transcatheter aortic valve implantation.

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Abbreviations

AR:

Aortic regurgitation

CMR:

Cardiac magnetic resonance

CT:

Computed tomography

ECG:

Electrocardiographic

ECV:

Myocardial extracellular volume

EF:

Ejection fraction

LGE:

Late gadolinium enhancement

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

LVOT:

Left ventricular outflow tract

MRI:

Magnetic resonance imaging

TAVI:

Transcatheter aortic valve implantation

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

2D:

Two-dimensional

3D:

Three-dimensional

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Authors and Affiliations

  1. Heart Institute, University Hospital Germans Trias I Pujol, Carretera de Canyet S/N, 08916, Badalona, Spain

    Elena Ferrer-Sistach, Albert Teis, Claudia Escabia & Victoria Delgado

  2. Center for Comparative Medicine and Bioimaging (CMCIB), Germans Trias I Pujol Research Institute (IGTP), Badalona, Spain

    Victoria Delgado

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Contributions

A.T. contributed with the section on cardiac magnetic resonance and provided the corresponding table and figures for that section. E.F. contributed with the section on echocardiography and provided the figures in that section. C.E. contributed with the section on computed tomography and provided the figures in that section. V.D. designed the outline, provided supervision and guidance in the writing of the review, contributed with the introduction and conclusions sections, merged all the sections, supervised figures and tables, revised all the sections. All the authors read and provided suggestions and final approval of the manuscript.

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Correspondence to Victoria Delgado.

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Victoria Delgado received speaker fees from Edwards Lifesciences, GE Healthcare, Novartis, Philips, and MSD and consulting fees from Novo Nordisk and Edwards Lifesciences. The remaining authors have no conflicts of interest.

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Ferrer-Sistach, E., Teis, A., Escabia, C. et al. Assessment of the Severity of Aortic Regurgitation by Noninvasive Imaging. Curr Cardiol Rep 26, 1–14 (2024). https://doi.org/10.1007/s11886-023-02011-4

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