Valvular heart disease: assessment of valve morphology and quantification using MR.

Détails

ID Serval
serval:BIB_FD2F8DF1AA10
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Valvular heart disease: assessment of valve morphology and quantification using MR.
Périodique
Herz
Auteur(s)
Schwitter J.
ISSN
0340-9937 (Print)
ISSN-L
0340-9937
Statut éditorial
Publié
Date de publication
2000
Volume
25
Numéro
4
Pages
342-355
Langue
anglais
Résumé
For clinical evaluation and decision-making in patients with valvular heart disease, the diagnostic armamentarium expands steadily. This evolution makes it difficult to choose the most appropriate approach for a specific valvular lesion. It may also reflect our uncertainty of what are the findings that best predict clinical outcome of patients, e.g. after surgery. Accordingly, for each type of valvular lesion, some pathopysiological considerations are stated in order to derive the most important measures that would allow optimal guidance of patients. Based on these considerations the value of an MR study is discussed for each valvular lesion. Newest advances in MR technology allow for highly accurate measurements of regurgitant volumes and hence, MR may be the method of choice for a quantitative evaluation of regurgitant valves. For assessment of stenosis severity, measurement of transvalvular pressure gradient is an appropriate measure and MR may not confer benefits over echocardiography, provided the ultrasound window is adequate (and stroke volume is in the normal range). With respect to surgical treatment, valvular morphology is of pivotal importance, particularly for the mitral valve, and echocardiography still appears to be the first line method. Little data relate lesion severity and/or morphology to clinical outcome. Conversely, the extent of cardiac adaptation to pressure- and/or volume-overload, i.e. ventricular remodeling, is a strong predictor of outcome, and is therefore most important for final judgement of the patient. For assessment of left and right ventricular remodeling, echocardiography typically provides all the necessary information. However, in special cases with discrepant findings, with inadequate ultrasound window, or in the preoperative work-up, MR may provide important information regarding cardiac adaptation to valvular lesion.
Mots-clé
Aortic Valve Insufficiency/diagnosis, Aortic Valve Insufficiency/ultrasonography, Aortic Valve Stenosis/diagnosis, Aortic Valve Stenosis/ultrasonography, Echocardiography, Doppler, Heart Catheterization, Heart Valve Diseases/diagnosis, Heart Valve Diseases/surgery, Heart Valve Prosthesis, Humans, Magnetic Resonance Imaging/contraindications, Mitral Valve Insufficiency/diagnosis, Mitral Valve Insufficiency/ultrasonography, Mitral Valve Stenosis/diagnosis, Mitral Valve Stenosis/ultrasonography
Pubmed
Web of science
Création de la notice
07/09/2011 20:57
Dernière modification de la notice
20/08/2019 17:28
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