Consistency of echocardiographic assessment of the severity of mitral regurgitation using volumetric and PISA methods with MRI data in patients with secondary mitral regurgitation with reduced ejection fraction

Objectives: to compare the consistency of echocardiographic Vmr and FR obtained by PISA and volumetric methods with Vmr and FR obtained by MRI in patients with secondary MR with reduced LV EF.

Materials and methods. The analysis included data from 433 patients with secondary mitral regurgitation with reduced LV EF (less than 35%). The patients were divided into 2 groups: Group 1 – 286 patients with an average age of 64 ± 10 years, in whom the calculation of R_vol and RF was carried out by the PISA method. Group 2 – 147 patients with an average age of 63 ± 11 years, in whom the calculation of R_vol and RF was carried out by the volumetric method.

Results. A moderate correlation was found between the indicators obtained by MRI and echocardiography, regardless of the method used, volumetric method R_vol r = 0.54 p = 0.01 and RF r = 0.56, p = 0.01, PISA method R_vol, r = 0.36, p = 0.01 and RF, r = 0.3, p = 0.01. The agreement in MR severity categorical scores between PISA and MRI was 27% in the diagnosis of severe mitral regurgitation and 50% in the diagnosis of moderate MR. The consistency in categorical MR severity scores between volumetric and MRI was 46% in the diagnosis of severe mitral regurgitation and 65% in the diagnosis of moderate MR. In the Bland–Altman analysis, the average difference in R_vol between PISA and MRI was 7.6 ± 13 ml with coincidence limits (30; –25 ml), the average difference in R_vol between volumetric and MRI was –2.5 ± 7.3 ml with coincidence limits (–12; 17 ml).

Conclusions. MRI and echocardiography regardless of the method used have only a moderate correlation in the assessment of Rvol and RF in patients with secondary MR with reduced EF. The volumetric method may be the method of choice when calculating quantitative indicators of MR severity, as it has better agreement with MRI data compared to the PISA method.

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