Abstract:
The evaluation of aortic regurgitation (AR) in bicuspid valve (BAV) is still a challenge because of the eccentricity of the jet, which may under/overestimate the regurgitation. The commonly used echocardiography parameters (such as vena contracta, pressure half-time, etc.) may not be useful in this kind of patient. A multimodality approach combining echocardiography, cardiac MRI, cardiac CT, and advanced technologies applied to non-invasive cardiac imaging (e.g., 4D flow and strain imaging) may be useful to better quantify regurgitation and to select patients suitable for valve replacement. This review provides an overview of the most recent insights about cardiovascular imaging tools and their utility in BAV evaluation, focusing on chronic regurgitation. We describe the role of multimodality imaging in both diagnosis and risk assessment of this disease, pointing out the advantages and disadvantages of the imaging techniques, aiming to provide a guide to clinicians and cardiovascular imaging specialists in choosing the best imaging tools to use.
摘要:
由于射流的偏心性,评价二尖瓣(BAV)的主动脉瓣反流(AR)仍然是一个挑战,这可能会低估/高估反流。常用的超声心动图参数(如静脉收缩、压力半衰期,等。)对这类病人可能没有用。结合超声心动图的多模态方法,心脏MRI,心脏CT,以及应用于非侵入性心脏成像的先进技术(例如,4D流量和应变成像)可能有助于更好地量化反流并选择适合瓣膜置换的患者。这篇综述概述了有关心血管成像工具及其在BAV评估中的应用的最新见解。专注于慢性反流。我们描述了多模态成像在这种疾病的诊断和风险评估中的作用。指出了成像技术的优缺点,旨在为临床医生和心血管成像专家提供选择最佳成像工具的指南。