Valvular Heart Disease (Aortic and Mitral Valves) Clinical Trial
Official title:
Role of Phase Contrast Magnetic Resonance in Regurgitant Valvular Heart Diseases
The ability to quantify flow directly using through-plane phase contrast velocity mapping is
a unique advantage of cardiovascular magnetic resonance and does not rely on the calculation
from complex equations as echocardiography.
The aim s is to study the role of cardiac MRI in the evaluation of valvular heart disease
through quantification of the impact of valvular lesions upon cardiac function by accurate
estimation of the left ventricular ejection fraction
Valvular heart disease is common and increases with age. In the past, valvular heart disease
was typically caused by rheumatic heart disease, which remains a significant public health
burden in developing countries. In industrialized nations, however, the rheumatic diseases
has fallen substantially and valvular heart disease is now mainly degenerative in origin.
Valvular heart disease encompasses a number of common cardiovascular conditions that account
for 10% to 20% of all cardiac surgical procedures.
Clinical examination is not a reliable guide to diagnosis or severity. This gap in the
clinical valvular heart disease and the late presentation of many with severe disease
emphasizes the importance of quantitative, high-quality cardiac imaging.
Imaging needs to assess: 1) valve morphology to determine the etiology and suitability for
invasive intervention; 2) hemodynamic severity; 3) remodeling of the left ventricle and right
ventricle; 4) involvement of the aorta and 5) the prediction of adverse cardiovascular
events.
A number of imaging modalities are currently available to evaluate valvular heart disease in
a comprehensive manner allowing correct assessment of both valve morphology and function.
Doppler-echocardiography is the most frequently used tool for this purpose because it is
cost-effective, widely available and, in the majority of the cases, provides sufficient
information for clinical patient management and possible surgical planning.
For a long time, cardiac catheterization and invasive angiography have been regarded as the
"gold standard". However, this invasive approach exposes patients to radiation and iodinated
contrast media, carrying the non-negligible risk of life-threatening complications but
nonetheless far from optimal especially regarding the precise quantification of valvular
regurgitation.
Due to considerable improvements in hard- and software design in the last decade, magnetic
resonance imaging has claimed its role as a central player in a large variety of cardiac
diseases offering unique information about the mechanism of valve disease, quantifying the
severity of disease, and discerning the consequences of the lesions including the effects on
left ventricular volume, left ventricular systolic function, and left atrial volumes. Because
of both its high accuracy and reproducibility, magnetic resonance imaging has become the
preferred imaging modality in an increasing number of clinical trials. Also in the field of
valvular heart disease, considerable progress has been achieved.
Today, cardiovascular magnetic resonance has a number of unique advantages over other imaging
modalities. It provides a view of the entire heart without limitations from inadequate
imaging windows or body habitus. Additionally, in some patients, information from clinical
history and physical examination or other diagnostic tests may be discordant with
echocardiographic findings where there is a significant clinical role for cardiovascular
magnetic resonance. cardiovascular magnetic resonance also can obtain imaging data in any
imaging plane prescribed by the scan operator, which makes it ideal for accurate
investigation of all cardiac valves: aortic, mitral, pulmonic, and tricuspid. It can be
considered an excellent adjunct to echocardiography for investigating patients with valve
disease.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT05895487 -
Study on Efficacy, Safety and Durability of the UniLine Prosthesis in the Treatment of Aortic and Mitral Valve Disease
|