Predicting Surgery Needs in Patients with Aortic Regurgitation
Author Information
Author(s): Myerson Saul G, D'Arcy Jo, Greenwood John P, Mohiaddin Raad, Karamitsos Theodoros D, Francis Jane M, Banning Adrian P, Christiansen Jonathan P, Neubauer Stefan
Primary Institution: University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR)
Hypothesis
Can CMR quantification of aortic regurgitation and LV volumes predict symptom development and the need for aortic valve surgery in asymptomatic patients?
Conclusion
CMR quantification of aortic regurgitation and LV volumes accurately predicts the progression to symptoms and the need for surgery.
Supporting Evidence
- Aortic regurgitant fraction was the best predictor of clinical outcome with an AUC of 0.93.
- Survival without surgery was 88% for patients with a regurgitant fraction <37%.
- Regurgitant volume >38mls and regurgitant volume index >25mls/m2 were also good predictors.
- LV volumetric indices predicted outcome, but less strongly than measures of regurgitation.
Takeaway
Doctors can use special heart scans to see how bad a heart valve problem is, which helps them decide if a patient needs surgery even if they don't feel sick.
Methodology
CMR was performed to quantify aortic regurgitation and LV volume indices, followed by clinical follow-up for up to 7 years.
Participant Demographics
Asymptomatic patients with moderate or severe aortic regurgitation.
Statistical Information
P-Value
p<0.0001
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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