Multimodal Cardiac Imaging in Aortic Regurgitation: From Pathophysiology to Diagnosis and Treatment Planning
7 affiliations
- 1Department of Cardiology and Internal Diseases, Military Institute of Medicine—National Research Institute, Szaserow Street 128, 04-141 Warsaw, Poland
- 2Division of Cardiovascular Imaging, St. Francis Hospital and Catholic Health, Roslyn, NY 11576, USA
- 3Minneapolis Heart Institute, Minneapolis, MN 55407, USA
- 4Baylor Scott & White, The Heart Hospital, Plano, TX 75039, USA
- 5Department of Cardiothoracic Surgery, St. Francis Hospital and Catholic Health, Roslyn, NY 11576, USA
- 6Ameer-ud-Din Medical College, Lahore, Pakistan
- 7Geisinger Medical Center, Wilkes-Barre, PA 18711, USA
Abstract
Aortic regurgitation (AR) is a complex and often misdiagnosed valvular heart disease. It is often asymptomatic for years, making early detection critical. Once symptoms develop, left ventricular dysfunction may already be irreversible. Timely and accurate grading of AR severity can guide clinical decision-making and improve survival rates. Delayed diagnosis increases the risk of heart failure, arrhythmias, and sudden cardiac death. Transthoracic echocardiography (TTE) is the first-line imaging modality, providing assessment of valve morphology, AR severity, left ventricular size and function, and aortic dimensions. When TTE is inconclusive or additional anatomical information is required, complementary imaging modalities provide incremental value. Transesophageal echocardiography often helps to define AR mechanism and is particularly relevant for valve repair assessment and procedural guidance. Cardiovascular magnetic resonance enables accurate quantification of regurgitant volume and fraction, detailed evaluation of ventricular remodeling, and detection of myocardial fibrosis. Cardiac computed tomography offers high-resolution characterization of the aorta and is increasingly important for surgical and transcatheter planning. In selected patients, multimodality imaging also helps evaluate prosthetic valve dysfunction and suspected infective endocarditis. This paper reviews the currently used imaging modalities and their clinical applicability, and proposes an integrated multimodality imaging approach to guide patient management in chronic AR.
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BibTeX
@article{maciorowska2026multimodal,
title = {{Multimodal Cardiac Imaging in Aortic Regurgitation: From Pathophysiology to Diagnosis and Treatment Planning}},
author = {Malgorzata Maciorowska and Ana Pastorino and Lin Wang and Sylvia Biso and Billal Tokhi and Nadira Hamid and Amro Alsaid and Xiaoli Ren and Timothy Carter and Abdullah Masood and Abdellaziz Dahou and Omar K. Khalique},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218521},
url = {https://www.mdpi.com/2077-0383/15/21/8521},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Multimodal Cardiac Imaging in Aortic Regurgitation: From Pathophysiology to Diagnosis and Treatment Planning
AU - Malgorzata Maciorowska
AU - Ana Pastorino
AU - Lin Wang
AU - Sylvia Biso
AU - Billal Tokhi
AU - Nadira Hamid
AU - Amro Alsaid
AU - Xiaoli Ren
AU - Timothy Carter
AU - Abdullah Masood
AU - Abdellaziz Dahou
AU - Omar K. Khalique
PY - 2026
DA - 2026/11/02
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218521
UR - https://www.mdpi.com/2077-0383/15/21/8521
AB - Aortic regurgitation (AR) is a complex and often misdiagnosed valvular heart disease. It is often asymptomatic for years, making early detection critical. Once symptoms develop, left ventricular dysfunction may already be irreversible. Timely and accurate grading of AR severity can guide clinical decision-making and improve survival rates. Delayed diagnosis increases the risk of heart failure, arrhythmias, and sudden cardiac death. Transthoracic echocardiography (TTE) is the first-line imaging modality, providing assessment of valve morphology, AR severity, left ventricular size and function, and aortic dimensions. When TTE is inconclusive or additional anatomical information is required, complementary imaging modalities provide incremental value. Transesophageal echocardiography often helps to define AR mechanism and is particularly relevant for valve repair assessment and procedural guidance. Cardiovascular magnetic resonance enables accurate quantification of regurgitant volume and fraction, detailed evaluation of ventricular remodeling, and detection of myocardial fibrosis. Cardiac computed tomography offers high-resolution characterization of the aorta and is increasingly important for surgical and transcatheter planning. In selected patients, multimodality imaging also helps evaluate prosthetic valve dysfunction and suspected infective endocarditis. This paper reviews the currently used imaging modalities and their clinical applicability, and proposes an integrated multimodality imaging approach to guide patient management in chronic AR.
SN - 2077-0383
ER -