Aortic stenosis reexpanded – a novel approach to determine aortic valve area with phase contrast cardiovascular magnetic resonance imaging

Abstract Background Transthoracic echocardiography (TTE) has become the diagnostic standard for evaluating aortic stenosis (AS) severity, mainly because of its advantages in comparison to gold cardiac catheterization. However, inaccuracies determining stroke volume (SV) and consequentially computing valve area (AVA) call a more precise dependable method. Phase contrast cardiovascular magnetic resonance imaging (PC-CMR) is an aspiring tool push these boundaries. Purpose The aim this study was validate novel simple approach based on PC-CMR against invasive echocardiographic determination SV AVA patients with moderate severe AS. Methods A total 50 or AS underwent TTE, catheterization CMR; by determined via plotting momentary flow across velocity. CMR measured directly volumetrically using cine images. Invasive were Fick principle Gorlin formula, respectively. TTE yielded continuity equation. Finally, gradients calculated modified Bernoulli Results showed strong correlation cine-CMR no significant bias (r: 0.730, p<0.001; PC-CMR: 85±31ml; cine-CMR: 85±19ml, p=0.829). Peak 65±29mmHg correlated inversely −0.371; p=0.008). Mean during whole systolic phase 0.544, p<0.001) small (AVA CMR: 0.78±0.25cm2 versus AVA: 0.70±0.23cm2, bias: 0.08cm2, p=0.017). Inter-methodical as TTE: 0.81±0.23cm2, r: 0.580, p<0.001, 0.11cm2, similar AVA. Conclusion provides great option yield reliable solid values Furthermore, continuous volumes velocities able determine easy reproducible manner. Our shines light potential non-invasive grading, especially cases where reaches limits clinical findings appear inconclusive. Funding Acknowledgement Type funding sources: None. Central IllustrationCine (l,r) (m) images