Buisman, Adriaan W. (2024) Cardiac Magnetic Resonance Imaging versus Echocardiography in the Estimation of the Severity of Mitral Valve Regurgitation. thesis, Medicine.
Full text available on request.Abstract
Introduction: Mitral valve regurgitation (MR) is the most prevalent valve disease. Depending upon the severity of disease, symptoms can vary from asymptomatic to severe heart failure and shock. Therefore, accurate classification of the severity of MR is essential. This is typically accomplished via echocardiogram. The resolution and inherent assumptions of echocardiographic quantification can make the MR estimates inaccurate. Cardiac magnetic resonance imaging (CMR) could provide an alternative with higher resolution than echo. In this study, CMR is compared against echo to see whether this provides a differing insight into the MR severity. Methods: After vetting of scans by quality and statistics, 113 patients were included. Severity scores (SNS) from 0-3 were determined for both groups based upon the descriptive severity. A paired Wilcoxon signed rank test was used to assess difference between the CMR and echo groups. Furthermore, linear regression was used to examine relationships between the difference between the SNS of the two groups (DS) and various patient factors, including age, aortic regurgitation, time between scans, BMI, and blood pressure. Results: There was a significant difference between the echo group and the CMR group, with a p value of 0.028. The MR was estimated as more severe by echo in 27.4% of cases, estimated as the same in 31.9% of cases and estimated as more severe by CMR in 40.7% of cases. None of the patient factors showed any correlation with DS. Conclusion: The differing severity estimation with CMR vs echo could have implications for patients, especially those whose severity was underestimated by echocardiogram. However, based on literature review, there are potential biases inherent to phase-contrast CMR and cine-CMR scans. There is limited consensus about how strong and how consistent this bias is. More research with invasive controls is needed to resolve this question.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Sinkeler, Steef |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Sep 2024 12:55 |
| Last Modified: | 06 Sep 2024 12:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3752 |
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