Although CT and echocardiography are most commonly used for planning and follow-up of structural and VHD interventions, MRI is playing an increasing role in this expanding field [35], capitalizing on the good spatial and temporal resolution, large field of view, and inherent tissue characterization available with MRI. Dyspnea-Suspected Cardiac Origin MRI Heart Function with Stress There is no relevant literature to support the use of MRI heart function with stress for the evaluation of dyspnea due to suspected VHD, ischemia excluded. Radiography Chest Chest radiography can provide information on heart failure in the setting of VHD. Diagnosis of specific valve abnormalities is limited, but radiographs may aid in identification of characteristic cardiac chamber and great vessel changes [44] as well as marked calcification of aortic root or mitral annulus. Rb-82 PET/CT Heart There is no relevant literature to support the use of Rb-82 PET/CT heart for the evaluation of dyspnea due to suspected VHD, ischemia excluded. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of single-photon emission computed tomography (SPECT) or SPECT/CT myocardial perfusion imaging (MPI) for the evaluation of dyspnea due to suspected VHD, ischemia excluded. US Echocardiography Transthoracic Resting TTE is the primary modality for diagnosis, assessment, and follow-up of native and prosthetic VHD [21,48], providing insights to anatomy, mechanism of disease, and hemodynamic impact. Evaluation of leaflet morphology is typically obtained first by echocardiography, with proposed schemes to distinguish unicuspid from bicuspid or tricuspid aortic valves [49], although there is reported a common (20%) reclassification of leaflet morphology as determined on surface echocardiography after MRI, CT, or TEE imaging [23], or internal review of echocardiography images [50].
Dyspnea Suspected Cardiac Origin Ischemia Already Excluded . Although CT and echocardiography are most commonly used for planning and follow-up of structural and VHD interventions, MRI is playing an increasing role in this expanding field [35], capitalizing on the good spatial and temporal resolution, large field of view, and inherent tissue characterization available with MRI. Dyspnea-Suspected Cardiac Origin MRI Heart Function with Stress There is no relevant literature to support the use of MRI heart function with stress for the evaluation of dyspnea due to suspected VHD, ischemia excluded. Radiography Chest Chest radiography can provide information on heart failure in the setting of VHD. Diagnosis of specific valve abnormalities is limited, but radiographs may aid in identification of characteristic cardiac chamber and great vessel changes [44] as well as marked calcification of aortic root or mitral annulus. Rb-82 PET/CT Heart There is no relevant literature to support the use of Rb-82 PET/CT heart for the evaluation of dyspnea due to suspected VHD, ischemia excluded. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of single-photon emission computed tomography (SPECT) or SPECT/CT myocardial perfusion imaging (MPI) for the evaluation of dyspnea due to suspected VHD, ischemia excluded. US Echocardiography Transthoracic Resting TTE is the primary modality for diagnosis, assessment, and follow-up of native and prosthetic VHD [21,48], providing insights to anatomy, mechanism of disease, and hemodynamic impact. Evaluation of leaflet morphology is typically obtained first by echocardiography, with proposed schemes to distinguish unicuspid from bicuspid or tricuspid aortic valves [49], although there is reported a common (20%) reclassification of leaflet morphology as determined on surface echocardiography after MRI, CT, or TEE imaging [23], or internal review of echocardiography images [50].