European heart journal. Cardiovascular Imaging · 2026
Relationship between the left-to-right ventricular volume ratio and aortic regurgitation severity: an echocardiographic and cardiac magnetic resonance imaging study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Altes Alexandre, Hanet Vincent, Cardot Bérengère, Vancraeynest David, Pasquet Agnès, Delelis François, Lebouazda Achwaq, Tartare Fanny, Tristram Domitille, Toledano Manuel, Silvestri Valentina, Gerber Bernhard L, Maréchaux Sylvestre
Аннотация
AIMS: Left ventricular (LV) enlargement in chronic aortic regurgitation (AR) is commonly assessed using diameters and volumes. However, these measures are influenced by body size, sex, and age. The left-to-right ventricular end-diastolic volume ratio (LV/RV ratio), assessed by cardiac magnetic resonance imaging (CMR) and known to remain close to 1 in healthy individuals, could provide a more individualized marker of LV remodeling in chronic AR.
METHODS AND RESULTS: This bi-centre study included 258 patients with chronic AR (median age: 55 years, 18% women) who underwent echocardiography (Echo) and CMR. LV and RV volumes were measured from cine-CMR images. Associations between the LV/RV ratio, conventional LV measures, and significant AR, defined as Grades 3-4 on Echo or aortic regurgitant fraction (AR-RegFrac) ≥ 33% on CMR, were analysed using area under the curve (AUC) and logistic regression. The median LV/RV ratio was 1.5 [1.3-1.9], increased with AR severity (P < 0.001), and correlated more strongly with AR-RegFrac (r = 0.67; P < 0.001) than conventional LV measures. The LV/RV ratio identified significant AR with good accuracy (Echo, AUC 0.77; CMR, AUC 0.83). A threshold of 1.5 provided balanced sensitivity and specificity (Se 71-84%, Sp 77-75%), while 1.8 ruled in significant AR with high specificity (Sp 91% for both modalities). The LV/RV ratio did not vary significantly by age or sex and showed consistent performance across subgroups.
CONCLUSION: The LV/RV ratio is a reliable and individualized marker of LV remodeling in chronic AR. These findings support its potential role in clinical assessment and further evaluation in outcome studies.
METHODS AND RESULTS: This bi-centre study included 258 patients with chronic AR (median age: 55 years, 18% women) who underwent echocardiography (Echo) and CMR. LV and RV volumes were measured from cine-CMR images. Associations between the LV/RV ratio, conventional LV measures, and significant AR, defined as Grades 3-4 on Echo or aortic regurgitant fraction (AR-RegFrac) ≥ 33% on CMR, were analysed using area under the curve (AUC) and logistic regression. The median LV/RV ratio was 1.5 [1.3-1.9], increased with AR severity (P < 0.001), and correlated more strongly with AR-RegFrac (r = 0.67; P < 0.001) than conventional LV measures. The LV/RV ratio identified significant AR with good accuracy (Echo, AUC 0.77; CMR, AUC 0.83). A threshold of 1.5 provided balanced sensitivity and specificity (Se 71-84%, Sp 77-75%), while 1.8 ruled in significant AR with high specificity (Sp 91% for both modalities). The LV/RV ratio did not vary significantly by age or sex and showed consistent performance across subgroups.
CONCLUSION: The LV/RV ratio is a reliable and individualized marker of LV remodeling in chronic AR. These findings support its potential role in clinical assessment and further evaluation in outcome studies.