Visual grading of valvular regurgitation is inferior to measurement - results from the VIAVA-study (VIsual Assessment of VAlvular Regurgitation)

Ozan Demirel* (First author), Paolo Di Stefano, Elke Boxhammer (Co-author), Thomas Wuppinger (Co-author), Christina Granitz (Co-author), Bjoern Goebel, Uta C. Hoppe (Co-author), Michael Lichtenauer (Co-author), Moritz Mirna (Last author)

*Corresponding author for this work

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

While the visual estimation of systolic left ventricular function by experienced examiners closely aligns with quantitative methodologies, the accuracy of visual estimation in determining the severity of valvular regurgitation using colour flow Doppler assessment of native heart valves remains largely unexplored. This study analysed the ability of 262 physicians to visually estimate the severity of 12 native valve regurgitations by grading colour Doppler transthoracic echocardiography loops in an online questionnaire. The assessments of the participants were compared to standardized quantitative evaluations conducted by certified echocardiography experts. Of the three valves to assess, evaluations by the participants showed the best correlation (Rs = 0.75, p < 0.0001) and agreement (percent agreement: 66.4%) with those of the experts in mitral valve regurgitation (MR). High agreement was observed for mild regurgitation across all valves (MR 94.5%, AR 80.3% and TR 88.7%), while consensus diminished in moderate (MR 55.9%, AR 49.5% and TR 55.0%) and severe regurgitation (MR 57.6%, AR 67.4%, TR 14.6%). The study underscores the potential utility of visual estimation of valvular regurgitation in clinical settings for identifying clinically relevant regurgitations. However, our findings also highlight the importance of integrating visual estimation with quantitative methods, particularly in moderate and severe cases of regurgitation.
Original languageEnglish
Article number26
Number of pages7
JournalEcho Research and Practice
Volume11
Issue number1
DOIs
Publication statusPublished - 11 Nov 2024

Keywords

  • Echocardiography
  • Quantitative Assessment
  • Valvular Regurgitation
  • Visual Estimation

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