Usefulness of cardiovascular magnetic resonance imaging for the evaluation of valve opening and closing kinetics in aortic stenosis.

AIMS The aims of this study were : (i) to determine the feasibility and reproducibility of the measurement of valve kinetic parameters by cardiovascular magnetic resonance (CMR) and (ii) to examine the association between these parameters and markers of a poor prognosis in patients with aortic stenosis (AS). METHODS AND RESULTS Eight healthy control subjects and 71 patients with AS (0.60 cm(2) ≤ EOA ≤ 1.90 cm(2)) underwent transthoracic echocardiography (TTE) and CMR. The valve opening slope (OS) and closing slope (CS) were calculated from instantaneous effective orifice area (EOA) curves obtained by CMR. Intra- and inter-observer variability were 4.8 ± 3.9 and 5.0 ± 4.1%, respectively, for OS, 3.8 ± 2.9 and 4.0 ± 3.1% for CS. OS was significantly related to the plasma level of NT-pro-brain natriuretic peptide (BNP) (r = -0.36, P = 0.002), whereas the EOA or gradient were not. CONCLUSION This study demonstrates the excellent feasibility and reproducibility of CMR for the measurement of valve kinetic parameters in patients with AS. Larger studies are needed to confirm the incremental prognostic value of these new CMR parameters of aortic valve kinetics in patients with severe AS.