Impact of measurement location on direct mitral regurgitation quantification using four-dimensional flow cardiovascular magnetic resonance

• DOI: 10.1016/j.jocmr.2025.101847
• Publication Date: 2025-01-26T06:38:33Z
• Authors: Adarsh Aratikatla; Taimur Safder; Gloria Ayuba; Vinesh Appadurai; Aakash Gupta; Michael Markl; James Thomas; Jeesoo Lee
• Keywords: Angiology; Functional mitral regurgitation; Cardiac magnetic resonance

Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) shows promise for quantifying mitral regurgitation (MR) by allowing direct regurgitant volume (RVol) measurement using a plane precisely placed at the MR jet. However, ideal location of remains unclear. This study aims to systematically examine how varying locations affect RVol quantification and determine optimal momentum conservation principle free Patients diagnosed with transthoracic echocardiography (TTE) scheduled CMR were prospectively recruited. Regurgitant jet (RVoljet) (RMomjet) quantified 4D 7 along axis, x. The reference (mid-plane, x=0mm) was positioned peak velocity each cardiac phase, 3 additional planes on either side jet, 2.5mm apart. RVoljet compared RVolTTE, measured proximal isovelocity surface area method RVolindirect, subtracting aortic forward from left ventricle stroke derived 2D phase-contrast valve stack short-axis cine techniques. RMomjet in 45 patients (age 63±13, male 26). In x=0mm ≥ 10ml (n=25), consistently increased as moved downstream. furthest upstream (x=-7.5mm) significantly lower (39±11%, p<0.001) downstream (x=7.5mm) higher (16±19%, than x=0mm. similarly x=-7.5 0mm (57±12%, but stabilized x=0 7.5mm (-2±17%). From 7.5mm, consistent moderate agreement RVolindirect (n=41, bias=-2±24 8±32ml, ICC=0.55 0.63, p<0.001). influences approach. Based converging profile RMomjet, we propose position.