A novel technique to quantify aortic valve annulus deformation: A pilot study

OBJECTIVES: We evaluated the potential of cardiac magnetic resonance (CMR)-derived strain to assess aortic valve (AV) annulus deformation during the cardiac cycle in regurgitant and well-functioning AVs.

METHODS: Four patients with severe aortic regurgitation and seven healthy controls underwent CMR. Assessment of longitudinal strain was performed by hypothesizing the AV annulus would be the left ventricle in long-axis orientation. Longitudinal strain of the segments belonging to the muscular and fibrous AV annulus was weighted and averaged to obtain regional values (RLS).

RESULTS: Comparison of RLS between regurgitant and well-functioning AVs showed a considerably different deformation of the muscular AV annulus (i.e., median RLS: 4.18 % [patients] vs. -10.41 % [controls], p = .024). The fibrous AV annulus demonstrated comparable deformational changes in both groups.

CONCLUSION: CMR-derived strain allows for quantification of AV annulus deformation during the cardiac cycle and shows an altered RLS in the muscular AV annulus in patients with severe aortic regurgitation.