Table 3.
Predictive accuracy of selected imaging markers to identify patients undergoing AV surgery.
| AUC (95% CI) | Cutoff Value | Sensitivity (%) | Specificity (%) | |
|---|---|---|---|---|
| Markers of LV remodeling | ||||
| 2D ECHO LVESD, mm | 0.69 (0.57–0.80) | 37 40 45 |
85 55 15 |
56 69 94 |
| 2D ECHO LVESDi, mm/m2 | 0.66 (0.54–0.78) | 18 20 22 |
80 30 15 |
53 75 90 |
| MRI LVEDV, mL | 0.68 (0.53–0.83) | 281 | 50 | 84 |
| MRI LVEDVi, mL/m2 | 0.69 (0.54–0.84) | 110 124 139 |
80 70 55 |
53 70 85 |
| MRI LVESV, mL | 0.64 (0.48–0.80) | 121 | 50 | 84 |
| MRI LVESVi, mL/m2 | 0.65 (0.49–0.81) | 42 56 58 |
70 60 50 |
53 77 81 |
| 2D ECHO GLS, % | 0.61 (0.47–0.70) | −17.5 | 50 | 71 |
| Markers of AR severity | ||||
| Diastolic flow reversal velocity, cm/s | 0.72 (0.59–0.85) | 22 | 65 | 78 |
| 2D ECHO RV, mL | 0.58 (0.43–0.74) | 93 | 40 | 88 |
| 2D ECHO RF, % | 0.61 (0.47–0.76) | 47 | 50 | 73 |
| 3D VCA (mm2) | 0.76 (0.64–0.88) | 29 31 36 |
80 75 65 |
63 71 81 |
| MRI RV, mL | 0.79 (0.70–0.88) | 41 45 |
95 90 |
56 61 |
| MRI RF, % | 0.77 (0.68–0.86) | 34 | 95 | 55 |
| Integrative approach | ||||
| 2D ECHO integrative approach | 0.65 (0.52–0.78) | Severe AR | 70 | 60 |
| 3D ECHO VCA ≥30 mm2 and 2D ECHO LVESD or LVESDi |
NA | LVESD >40 mm LVESD >45 mm LVESDi >20 mm/m2 LVESDi >22 mm/m2 |
80 80 80 80 |
71 97 77 87 |
| MRI regurgitant volume ≥45 mL and MRI LVEDVi or LVESVi |
NA | LVEDVi >139 mL/m2 LVESVI >62 mL/m2 |
90 90 |
78 78 |
| MRI regurgitant fraction ≥34% and MRI LVEDVi or LVESVi |
NA | LVEDVi >139 mL/m2 LVESVI >62 mL/m2 |
95 95 |
89 89 |
2D, two-dimensional; 3D, three dimensional, AUC, area under curve; ECHO, echocardiography; GLS, global longitudinal strain; LV, left ventricle; LVEDV, left ventricular end-diastolic volume; LVEDVi, left ventricular end-diastolic volume index; LVESD, left ventricular end-systolic diameter; LVESDi, left ventricular end-systolic diameter index; LVESV, left ventricular end-systolic volume; LVESVi, left ventricular end-systolic volume index; MRI, magnetic resonance imaging; RF, regurgitant fraction; RV, regurgitant volume; VCA, vena contracta area.