New Techniques to Evaluate Mitral Regurgitation
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 4/5/2019 |
| Start Date: | February 1, 2010 |
| End Date: | April 11, 2018 |
Background:
- Mitral regurgitation, or leaking of the mitral heart valve, is usually studied and assessed
with an ultrasound test called a two-dimensional (2D) echocardiogram. While this test has
proved very useful, technological improvements have helped researchers develop ways to study
the heart valves using imaging with three-dimensional (3D) capabilities. In addition,
recently developed magnetic resonance imaging (MRI) techniques may be able to provide better
information about the causes and severity of the leak. Researchers are interested in testing
these new techniques to determine their usefulness for patients with mitral regurgitation.
Objectives:
- To evaluate newer methods of studying mitral regurgitation severity using real-time 3D
echocardiography (RT3DE) and cardiac magnetic resonance imaging (CMRI).
Eligibility:
- Individuals at least 21 years of age who have been diagnosed with more than mild mitral
regurgitation.
Design:
- Participants will have two procedures as part of this study: an echocardiogram and an
MRI scan.
- For the echocardiogram, participants will have an ultrasound scan with a special kind of
probe. Participants may also receive an injection of a contrast agent to provide a
better image of the heart on the scan. The scan will take approximately 1 hour to
complete.
- For the MRI scan, participants will have a standard MRI with special pads placed on the
chest to provide better imaging of the heart. The scan will usually take between 45 and
90 minutes to complete.
- Mitral regurgitation, or leaking of the mitral heart valve, is usually studied and assessed
with an ultrasound test called a two-dimensional (2D) echocardiogram. While this test has
proved very useful, technological improvements have helped researchers develop ways to study
the heart valves using imaging with three-dimensional (3D) capabilities. In addition,
recently developed magnetic resonance imaging (MRI) techniques may be able to provide better
information about the causes and severity of the leak. Researchers are interested in testing
these new techniques to determine their usefulness for patients with mitral regurgitation.
Objectives:
- To evaluate newer methods of studying mitral regurgitation severity using real-time 3D
echocardiography (RT3DE) and cardiac magnetic resonance imaging (CMRI).
Eligibility:
- Individuals at least 21 years of age who have been diagnosed with more than mild mitral
regurgitation.
Design:
- Participants will have two procedures as part of this study: an echocardiogram and an
MRI scan.
- For the echocardiogram, participants will have an ultrasound scan with a special kind of
probe. Participants may also receive an injection of a contrast agent to provide a
better image of the heart on the scan. The scan will take approximately 1 hour to
complete.
- For the MRI scan, participants will have a standard MRI with special pads placed on the
chest to provide better imaging of the heart. The scan will usually take between 45 and
90 minutes to complete.
Echocardiography is currently the technique of choice to assess the etiology and severity of
mitral regurgitation (MR). Multiple 2D and Doppler parameters are assessed in an integrated
fashion and the proximal flow convergent zone of the mitral regurgitation jet is used to
calculate effective regurgitant orifice area and regurgitant volume. These measurements have
been shown to have important prognostic information. In the last two years, the development
of transesophageal imaging with 3D capability has allowed a better visualization of mitral
leaflet pathology. Color Doppler 3D studies have shown that 2D methods generally
underestimate mitral regurgitant volume. Magnetic resonance techniques have recently been
developed to quantitate flow and calculate regurgitant volumes.
The purpose of this study is to evaluate newer methods of quantitating mitral regurgitation
severity using real-time 3D echocardiography (RT3DE) and cardiac magnetic resonance imaging
(CMR). Although RT3DE measurements have been shown to correlate well with CMR measures of LV
volumes, using a 3D volumetric method to calculate mitral regurgitant volumes has not been
well studied. In patients with more than mild mitral regurgitation, we will obtain
transthoracic RT3DE measures of mitral regurgitant volume and compare them with traditional
2D measures of MR severity. We will also compare RT3DE and CMR measures of mitral regurgitant
volume.
mitral regurgitation (MR). Multiple 2D and Doppler parameters are assessed in an integrated
fashion and the proximal flow convergent zone of the mitral regurgitation jet is used to
calculate effective regurgitant orifice area and regurgitant volume. These measurements have
been shown to have important prognostic information. In the last two years, the development
of transesophageal imaging with 3D capability has allowed a better visualization of mitral
leaflet pathology. Color Doppler 3D studies have shown that 2D methods generally
underestimate mitral regurgitant volume. Magnetic resonance techniques have recently been
developed to quantitate flow and calculate regurgitant volumes.
The purpose of this study is to evaluate newer methods of quantitating mitral regurgitation
severity using real-time 3D echocardiography (RT3DE) and cardiac magnetic resonance imaging
(CMR). Although RT3DE measurements have been shown to correlate well with CMR measures of LV
volumes, using a 3D volumetric method to calculate mitral regurgitant volumes has not been
well studied. In patients with more than mild mitral regurgitation, we will obtain
transthoracic RT3DE measures of mitral regurgitant volume and compare them with traditional
2D measures of MR severity. We will also compare RT3DE and CMR measures of mitral regurgitant
volume.
- INCLUSION CRITERIA:
- Adult patient, age greater than or equal to 21 years
- Able to give written informed consent
- Prior cardiac testing clinically read as having greater than mild MR
EXCLUSION CRITERIA:
- Atrial fibrillation or other irregular rhythm that would preclude adequate 3D image
acquisition
- History of valve surgery or significant valve disease other than mitral regurgitation
- Patients with pacemakers, defibrillators, cerebral aneurysm clips, neural stimulators,
ear implants or other clinical contra-indications for magnetic resonance scanning will
be excluded from the CMR portion of the study
- Any unstable condition that would make additional imaging time inadvisable (in the
opinion of the investigator or managing physician)
- Pregnant or lactating women
We found this trial at
2
sites
Suburban Hospital Suburban Hospital is a community-based, not-for-profit hospital serving Montgomery County and the surrounding...
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9000 Rockville Pike
Bethesda, Maryland 20892
Bethesda, Maryland 20892
Phone: 800-411-1222
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