Assessing Regurgitation Severity, Adverse Remodeling, and Fibrosis with CMR in Aortic Regurgitation

Curr Cardiol Rep. 2024 May;26(5):413-421. doi: 10.1007/s11886-024-02044-3. Epub 2024 Mar 22.

Abstract

Purpose of review: Cardiac magnetic resonance (CMR) is emerging as a valuable imaging modality for the assessment of aortic regurgitation (AR). In this review, we discuss the assessment of AR severity, left ventricular (LV) remodeling, and tissue characterization by CMR while highlighting the latest studies and addressing future research needs.

Recent findings: Recent studies have further established CMR-based thresholds of AR severity and LV remodeling that are associated with adverse clinical outcomes, and lower than current guideline criteria. In addition, tissue profiling with late gadolinium enhancement (LGE) and extracellular volume (ECV) quantification can reliably assess adverse myocardial tissue remodeling which is also associated with adverse outcomes. The strengths and reproducibility of CMR in evaluating ventricular volumes, tissue characteristics, and regurgitation severity position it as an excellent modality in evaluating and following AR patients. Advanced CMR techniques for the detection of tissue remodeling have shown significant potential and merit further investigation.

Keywords: Aortic regurgitation; Cardiac magnetic resonance; Myocardial fibrosis; Myocardial remodeling; Phase-contrast imaging.

Publication types

  • Review

MeSH terms

  • Aortic Valve Insufficiency* / diagnostic imaging
  • Aortic Valve Insufficiency* / physiopathology
  • Contrast Media
  • Fibrosis* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging, Cine / methods
  • Reproducibility of Results
  • Severity of Illness Index*
  • Ventricular Remodeling*

Substances

  • Contrast Media