This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Aortic regurgitation AR in children can be congenital or acquired e.g. bacterial endocarditis, rheumatic fever, or post arterial switch operation for transposition A reliable method for measuring the magnitude of aortic regurgitation is necessary, because even mild AR may gradually increase in severity, eventually requiring an aortic valve operation, because of symptoms, left ventricular LV dysfunction, or both. Guidelines established for determining the severity of AR and timing of surgical intervention in adults, but no such guidelines exist for children. In children, timing of intervention is typically based on progression of AR and consequent LV dilation and dysfunction, symptoms, and physician preference. Methods of AR evaluation include cardiac catheterization, radionuclide studies, exercise stress tests, and resting Echo. Each has limitations. Catheterization and nuclear studies involve radiation exposure, with catheterization being additionally invasive. Exercise treadmill testing provides a clinical assessment dependent on participant effort. Echo, a readily available non-invasive ultrasound method, is subject to significant error due to dependence on the operator, reader, acoustic windows, and mathematical assumptions of ventricular geometry. CMRI offers a more accurate, non-invasive imaging assessment of LV dimensions and function, and blood flow in persons with normal cardiac anatomy or with congenital/ acquired heart disease, because image quality is not limited by acoustic windows and because multiple cardiac segments are analyzed. CMRI involves no radiation exposure. Our pilot study will compare the measurement of aortic valve regurgitation and resulting LV morphology/ function obtained by high quality 1.5T CMRI with Echo for 25 pediatric subjects.
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