Table 1
Open in new tab

Standard and novel myocardial imaging biomarkers that showed diagnostic and prognostic value in the management of patients with degenerative valvular heart disease

Myocardial imaging biomarker
EchocardiographyCMR
Primary mitral regurgitation
Standard

  • LVEDD

  • LVEF

  • LA diameter

  • LA volume

  • PAPs

  • RV dimension and function (TAPSE, FAC)

  • LVEDD

  • LV volumes and EF

  • LV hypertrophy/mass

  • RV volumes and function

New

  • LV GLS

  • LV mechanical dispersion

  • LA reservoir strain

  • 3D LV volumes

  • LGE (replacement fibrosis)

    • Extent

    • Location

  • ECV (interstitial fibrosis)

  • GLS

Aortic stenosis
Standard

  • LVEF

  • LV dilatation

  • LV hypertrophy

  • Stress echocardiography

  • LVEF

  • LV mass/hypertrophy

New

  • LV GLS

  • LV myocardial work indices

  • LGE (replacement fibrosis)

  • ECV (interstitial fibrosis)

  • Amyloidosis assessment (including nuclear imaging)

  • GLS

  • T2

  • Perfusion for detection of epicardial coronary artery and/or microvascular disease

Aortic regurgitation
Standard

  • LVEDD and LVESD

  • LVEF

  • Stress echocardiography

  • LV volumes and EF

  • LV hypertrophy/mass

  • LV diameters

New

  • LV GLS

  • LV myocardial work indices

  • 3D LV volumes

  • LGE

  • ECV

  • GLS

Tricuspid regurgitation
Standard

  • RV dimension/area

  • TAPSE

  • FAC

  • RV volumes and EF

  • RV mass

  • RA area and volume

New

  • RV-PA coupling

  • 3D RV volume and EF

  • RV strain

  • LGE

  • ECV

  • RV strain

Myocardial imaging biomarker
EchocardiographyCMR
Primary mitral regurgitation
Standard

  • LVEDD

  • LVEF

  • LA diameter

  • LA volume

  • PAPs

  • RV dimension and function (TAPSE, FAC)

  • LVEDD

  • LV volumes and EF

  • LV hypertrophy/mass

  • RV volumes and function

New

  • LV GLS

  • LV mechanical dispersion

  • LA reservoir strain

  • 3D LV volumes

  • LGE (replacement fibrosis)

    • Extent

    • Location

  • ECV (interstitial fibrosis)

  • GLS

Aortic stenosis
Standard

  • LVEF

  • LV dilatation

  • LV hypertrophy

  • Stress echocardiography

  • LVEF

  • LV mass/hypertrophy

New

  • LV GLS

  • LV myocardial work indices

  • LGE (replacement fibrosis)

  • ECV (interstitial fibrosis)

  • Amyloidosis assessment (including nuclear imaging)

  • GLS

  • T2

  • Perfusion for detection of epicardial coronary artery and/or microvascular disease

Aortic regurgitation
Standard

  • LVEDD and LVESD

  • LVEF

  • Stress echocardiography

  • LV volumes and EF

  • LV hypertrophy/mass

  • LV diameters

New

  • LV GLS

  • LV myocardial work indices

  • 3D LV volumes

  • LGE

  • ECV

  • GLS

Tricuspid regurgitation
Standard

  • RV dimension/area

  • TAPSE

  • FAC

  • RV volumes and EF

  • RV mass

  • RA area and volume

New

  • RV-PA coupling

  • 3D RV volume and EF

  • RV strain

  • LGE

  • ECV

  • RV strain

ECV, extracellular volume; EDD, end-diastolic diameter; EF, ejection fraction; FAC, fractional area change; GLS, global longitudinal strain; LA, left atrium; LGE, late gadolinium enhancement; LV, left ventricle; PAPs, systolic pulmonary artery pressure; RV, right ventricle; TAPSE, tricuspid annular plane systolic excursion.

Table 1
Open in new tab

Standard and novel myocardial imaging biomarkers that showed diagnostic and prognostic value in the management of patients with degenerative valvular heart disease

Myocardial imaging biomarker
EchocardiographyCMR
Primary mitral regurgitation
Standard

  • LVEDD

  • LVEF

  • LA diameter

  • LA volume

  • PAPs

  • RV dimension and function (TAPSE, FAC)

  • LVEDD

  • LV volumes and EF

  • LV hypertrophy/mass

  • RV volumes and function

New

  • LV GLS

  • LV mechanical dispersion

  • LA reservoir strain

  • 3D LV volumes

  • LGE (replacement fibrosis)

    • Extent

    • Location

  • ECV (interstitial fibrosis)

  • GLS

Aortic stenosis
Standard

  • LVEF

  • LV dilatation

  • LV hypertrophy

  • Stress echocardiography

  • LVEF

  • LV mass/hypertrophy

New

  • LV GLS

  • LV myocardial work indices

  • LGE (replacement fibrosis)

  • ECV (interstitial fibrosis)

  • Amyloidosis assessment (including nuclear imaging)

  • GLS

  • T2

  • Perfusion for detection of epicardial coronary artery and/or microvascular disease

Aortic regurgitation
Standard

  • LVEDD and LVESD

  • LVEF

  • Stress echocardiography

  • LV volumes and EF

  • LV hypertrophy/mass

  • LV diameters

New

  • LV GLS

  • LV myocardial work indices

  • 3D LV volumes

  • LGE

  • ECV

  • GLS

Tricuspid regurgitation
Standard

  • RV dimension/area

  • TAPSE

  • FAC

  • RV volumes and EF

  • RV mass

  • RA area and volume

New

  • RV-PA coupling

  • 3D RV volume and EF

  • RV strain

  • LGE

  • ECV

  • RV strain

Myocardial imaging biomarker
EchocardiographyCMR
Primary mitral regurgitation
Standard

  • LVEDD

  • LVEF

  • LA diameter

  • LA volume

  • PAPs

  • RV dimension and function (TAPSE, FAC)

  • LVEDD

  • LV volumes and EF

  • LV hypertrophy/mass

  • RV volumes and function

New

  • LV GLS

  • LV mechanical dispersion

  • LA reservoir strain

  • 3D LV volumes

  • LGE (replacement fibrosis)

    • Extent

    • Location

  • ECV (interstitial fibrosis)

  • GLS

Aortic stenosis
Standard

  • LVEF

  • LV dilatation

  • LV hypertrophy

  • Stress echocardiography

  • LVEF

  • LV mass/hypertrophy

New

  • LV GLS

  • LV myocardial work indices

  • LGE (replacement fibrosis)

  • ECV (interstitial fibrosis)

  • Amyloidosis assessment (including nuclear imaging)

  • GLS

  • T2

  • Perfusion for detection of epicardial coronary artery and/or microvascular disease

Aortic regurgitation
Standard

  • LVEDD and LVESD

  • LVEF

  • Stress echocardiography

  • LV volumes and EF

  • LV hypertrophy/mass

  • LV diameters

New

  • LV GLS

  • LV myocardial work indices

  • 3D LV volumes

  • LGE

  • ECV

  • GLS

Tricuspid regurgitation
Standard

  • RV dimension/area

  • TAPSE

  • FAC

  • RV volumes and EF

  • RV mass

  • RA area and volume

New

  • RV-PA coupling

  • 3D RV volume and EF

  • RV strain

  • LGE

  • ECV

  • RV strain

ECV, extracellular volume; EDD, end-diastolic diameter; EF, ejection fraction; FAC, fractional area change; GLS, global longitudinal strain; LA, left atrium; LGE, late gadolinium enhancement; LV, left ventricle; PAPs, systolic pulmonary artery pressure; RV, right ventricle; TAPSE, tricuspid annular plane systolic excursion.

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