Cardiovascular Magnetic Resonance Imaging for Valvular Heart Disease: Technique and Validation

Abstract

O ver the last half century, clinicians have employed several means to advance our knowledge of the causes and consequences of valvular heart disease.Invasive cardiac catheterization provided valuable information about hemodynamics, 2-dimensional (2D) echocardiography (echo) allowed direct visualization of the valvular apparatus and cardiac chambers, and Doppler echocardiography afforded a noninvasive tool for assessing hemodynamics and disease severity.Echocardiography is now the standard tool for initial assessment and longitudinal evaluation of patients with valvular heart disease; however, echocardiography is limited in patients with poor acoustic windows and may be more operator dependent than other modalities, particularly for quantitation of disease severity.In the last 20 years, cardiovascular magnetic resonance (CMR) has emerged as an alternative noninvasive modality without ionizing radiation that is applicable to patients with valvular heart disease.CMR provides images of valve anatomy and allows quantitative evaluation of stenosis and regurgitation.CMR can also discern the consequences of the valvular lesion, including the effects of ventricular volume or pressure overload and alterations in systolic function.The purpose of the present review is to summarize the general principles of CMR and validate CMR as a tool for evaluation of valvular heart disease.