ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2021
Direct mitral regurgitation quantification in hypertrophic cardiomyopathy using 4D flow CMR jet tracking: evaluation in comparison to conventional CMR.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Evaluation of tricuspid regurgitation by cardiac magnetic resonance and comparison with echocardiography: a systematic review.The international journal of cardiovascular imaging · 2025Pooled it
- Quantification of Tricuspid Valve Regurgitation With 2D and 4D-Flow MRI: Comparison of Different Methods in Adult Patients With Ebstein's Anomaly.Journal of magnetic resonance imaging : JMRI · 2026Article
- Automated Deep Learning Based Cardiac Quantification in Hypertrophic Cardiomyopathy: A Comparative Study with Manual Segmentation.Acta medica Lituanica · 2025Article
- Quadratic stratification of left ventricular hypertrophy and association with mitral insufficiency grading: a retrospective study using cardiac magnetic resonance.Cardiovascular diagnosis and therapy · 2024Article
- Deep learning based automated left ventricle segmentation and flow quantification in 4D flow cardiac MRI.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Article
- Feasibility of Wave Intensity Analysis from 4D Cardiovascular Magnetic Resonance Imaging Data.Bioengineering (Basel, Switzerland) · 2023Article
- To Include or Not to Include: Quantification of Mitral Regurgitation in Patients with Mitral Valve Prolapse Using Cardiac MRI.Radiology. Cardiothoracic imaging · 2023Article
- Cardiac Multimodality Imaging in Hypertrophic Cardiomyopathy: What to Look for and When to Image.Current cardiology reviews · 2023Review
- 2021-2022 state of our JCMR.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022Review
- The Role of Cardiovascular Magnetic Resonance in Patients with Mitral Regurgitation.Journal of cardiovascular development and disease · 2022Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundQuantitative evaluation of mitral regurgitation (MR) in hypertrophic cardiomyopathy (HCM) by cardiovascular magnetic resonance (CMR) relies on an indirect volumetric calculation. The aim of this study was to directly assess and quantify MR jets in patients with HCM using 4D flow CMR jet tracking in comparison to standard-of-care CMR indirect volumetric method.
methodsThis retrospective study included patients with HCM undergoing 4D flow CMR. By the indirect volumetric method from CMR, MR volume was quantified as left ventricular stroke volume minus forward aortic volume. By 4D flow CMR direct jet tracking, multiplanar reformatted planes were positioned in the peak velocity of the MR jet during systole to calculate through-plane regurgitant flow. MR severity was collected for agreement analysis from a clinical echocardiograms performed within 1 month of CMR. Inter-method and inter-observer agreement were assessed by intraclass correlation coefficient (ICC), Bland-Altman analysis, and Cohen's kappa.
resultsThirty-seven patients with HCM were included. Direct jet tracking demonstrated good inter-method agreement of MR volume compared to the indirect volumetric method (ICC = 0.80, p = 0.004) and fair agreement of MR severity (kappa = 0.27, p = 0.03). Direct jet tracking showed higher agreement with echocardiography (kappa = 0.35, p = 0.04) than indirect volumetric method (kappa = 0.16, p = 0.35). Inter-observer reproducibility of indirect volumetric method components revealed the lowest reproducibility in end-systolic volume (ICC = 0.69, p = 0.15). Indirect volumetric method showed good agreement of MR volume (ICC = 0.80, p = 0.003) and fair agreement of MR severity (kappa = 0.38, p < 0.001). Direct jet tracking demonstrated (1) excellent inter-observer reproducibility of MR volume (ICC = 0.97, p < 0.001) and MR severity (kappa = 0.84, p < 0.001) and (2) excellent intra-observer reproducibility of MR volume (ICC = 0.98, p < 0.001) and MR severity (kappa = 0.88, p < 0.001).
conclusionsQuantifying MR and assessing MR severity by indirect volumetric method in HCM patients has limited inter-observer reproducibility. 4D flow CMR jet tracking is a potential alternative technique to directly quantify and assess MR severity with excellent inter- and intra-observer reproducibility and higher agreement with echocardiography in this population.
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