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[en] Current echocardiographic data reporting the impact of concomitant mitral regurgitation (MR) on outcome in patients who undergo transcatheter aortic valve replacement (TAVR) are conflicting. Using cardiovascular magnetic resonance (CMR) imaging, this study aimed to assess the impact of MR severity on cardiac reverse remodeling and patient outcome. 85 patients undergoing TAVR with CMR pre- and 6 m post-TAVR were evaluated. The CMR protocol included cines for left (LV) and right ventricular (RV) volumes, flow assessment, and myocardial scar assessment by late gadolinium enhancement (LGE). Patients were dichotomised according to CMR severity of MR fraction at baseline (‘non-significant’ vs ‘significant’) and followed up for a median duration of 3 years. Forty-two (49%) patients had ‘significant MR’ at baseline; they had similar LV and RV size and function compared to the ‘non-significant MR’ group but had greater LV mass at baseline. In those with significant MR at baseline, 77% (n = 32) had a reduction in MR post-TAVR, moving them into the ‘non-significant’ category at 6-months, with an overall reduction in MR fraction from 34 to 17% (p < 0.001). Improvement in MR was not associated with more favourable cardiac reverse remodeling when compared with the ‘non-improvers’. Significant MR at baseline was not associated with increased mortality at follow-up. Significant MR is common in patients undergoing TAVR and improves in the majority post-procedure. Improvement in MR was not associated with more favourable LV reverse remodeling and baseline MR severity was not associated with mortality.
[en] Objective: To prospectively compare a selective short axis slice positioning method (selective 3-of-5) used in combination with a single long-axis slice, to the conventional short axis multi-slice technique in the assessment of myocardial viability. Materials and methods: Thirty-one patients with recent or chronic ST segment elevation myocardial infarct (STEMI) were recruited to undergo delayed enhancement (DE) cardiac magnetic resonance imaging (CMR). All patients underwent both methods of DE imaging, with subsequent review of both sets of data by two experienced observers. Sensitivity and specificity, as well as intra and interobserver reproducibility for both techniques were assessed. Results: There was good agreement between the selective 3-of-5 and the conventional multi-slice method for the assessment of viability, with no significant difference in results for sensitivity or reproducibility between the techniques. Conclusion: In patients with STEMI, a selective 3-of-5 short axis slice acquisition used in combination with a single vertical long-axis slice can be utilised to produce a standard American Heart Association (AHA) 17-segment model for the assessment of myocardial viability