Comparing 2D and 3D Echocardiography with Cardiac MRI for Valvular Heart Disease and Ventricular Function Assessment

What this Trial Is About

Researchers are evaluating different 2D and 3D echocardiography methods to measure the severity of valvular heart disease, including Doppler, PISA, VCA, and volumetric techniques. The study focuses on patients with aortic stenosis, aortic regurgitation, and mitral valve regurgitation. It aims to compare these methods with cardiac magnetic resonance CMR, considered the reference standard, to assess left and right ventricular function, strain, and myocardial fibrosis. The study also explores whether the extent of myocardial fibrosis predicts symptom development, valve surgery referrals, and heart remodeling, and will examine patients undergoing cardiac resynchronization therapy CRT implantation to predict therapy response. Participants will undergo 2D and 3D transthoracic echocardiography TTE and CMR, including strain measurements and myocardial fibrosis assessment. Some patients will participate in a substudy involving exercise stress MRI with a supine bicycle. At enrollment, questionnaires assessing physical activity and heart failure symptoms will be completed, with follow-up at 6 to 12 months including a non-contrast cardiac MRI and repeat questionnaires. Outcomes will be tracked through medical records and death registries. Monitoring during the exercise MRI includes ECG, blood pressure, heart rate, and symptom assessments, with safety measures in place. Throughout the study, participants will complete questionnaires, undergo various cardiac imaging tests, and have their clinical outcomes followed for events such as hospitalizations, valve interventions, and mortality. The main outcomes measured at 6 months include changes in left ventricular volumes and function by MRI, symptom scores, physical activity levels, mortality, and indications for valve surgery. The study seeks to provide detailed comparisons of imaging methods and understand how myocardial fibrosis relates to clinical outcomes in valvular heart disease.

Comparative Imaging Assessment of Valvular Heart Disease