Pour savoir comment effectuer et gérer un dépôt de document, consultez le « Guide abrégé – Dépôt de documents » sur le site Web de la Bibliothèque. Pour toute question, écrivez à corpus@ulaval.ca.
 

Personne :
Larose, Éric

En cours de chargement...
Photo de profil

Adresse électronique

Date de naissance

Projets de recherche

Structures organisationnelles

Fonction

Nom de famille

Larose

Prénom

Éric

Affiliation

Université Laval. Faculté de médecine

ISNI

ORCID

Identifiant Canadiana

ncf11860485

person.page.name

Résultats de recherche

Voici les éléments 1 - 10 sur 16
  • PublicationAccès libre
    Dobutamine stress echocardiography for management of low-flow, low-gradient aortic stenosis
    (Elsevier Biomedical, 2018-01-29) Dahou, Abdellaziz; Larose, Éric; Annabi, Mohamed Salah; Burwash, Ian G.; Touboul, Eden; Bergler-Klein, Jutta; Pibarot, Philippe; Enriquez-Sarano, Maurice; Clavel, Marie-Annick; Orwat, Stefan; Baumgartner, Helmut; Mascherbauer, Julia; Mundigler, Gerald; Cavalcante, João L.
    Background: Dobutamine stress echocardiography (DSE) is useful to differentiate true from pseudo severe aortic stenosis in patients with low left ventricular ejection fraction (LVEF), low-flow, low-gradient aortic stenosis (LF-LG AS). In the ACC/AHA guidelines, patients are considered having true-severe stenosis when the mean gradient (MG) is ≥40mmHg with an aortic valve area (AVA) ≤1cm2 during DSE. However these criteria have not been previously validated. The aim of this study was to assess the value of these criteria to predict the presence of true-severe AS and the occurrence of death in patients with LFLG AS. Methods: In the TOPAS (“True or Pseudo-Severe Aortic Stenosis”) study, 186 patients with low LVEF LF-LG AS were prospectively recruited and underwent DSE with measurement of the MG, AVA and projected AVA, an estimate of the AVA at a standardized normal flow rate (AVAProj). Severity of AS was independently corroborated by macroscopic evaluation of the valve at the time of valve replacement in 54 patients and by measurement of the aortic valve calcium by computed tomography in 25 patients and by both methods in 8. According to these assessments, 50/87 (57%) of the study cohort had true-severe stenosis. Results: Peak stress MG ≥40 mmHg, peak stress AVA ≤1cm2, and the combination of peak stress MG ≥40 mmHg and peak stress AVA≤1cm2 correctly classified AS severity in 48%, 60%, and 47% of patients, respectively, whereas AVAProj ≤1cm2 was better than all the previous markers (p<0.007) with 70% of correct classification. Among the subset of 88 patients managed conservatively (47% of cohort), 52 died during a follow-up of 2.8±2.5 years. After adjustment for age, sex, functional capacity, chronic kidney failure and peak stress LVEF, peak stress MG and AVA were not predictors of mortality in this subset. In contrast, AVAProj ≤1cm2 was a strong predictor of mortality under medical management (HR: 3.65; p=0.0003). Conclusion: In patients with low LVEF LF-LG AS, the DSE criteria of peak stress MG≥40 mmHg, or the composite of peak stress MG≥40 mmHg and peak stress AVA≤1cm2 proposed in the guidelines to identify true-severe AS and recommend valve replacement, have limited value to predict actual stenosis severity and outcomes. In contrast, AVAProj better distinguishes true from pseudo-severe aortic stenosis and is strongly associated with mortality in patients under conservative management.
  • PublicationAccès libre
    Relationship between QT interval and outcome in low-flow low-gradient aortic stenosis with low left ventricular ejection fraction
    (John Wiley & Sons, 2016-10-20) Dahou, Abdellaziz; Toubal, Oumhani; Larose, Éric; Magne, Julien; Rodés-Cabau, Josep; Beaudoin, Jonathan; Philippon, François; Pibarot, Philippe; Dumesnil, Jean G.; Clavel, Marie-Annick; Puri, Rishi; Mathieu, Patrick; Ribeiro, Henrique B.
    Background QT interval has been shown to be associated with cardiovascular events. There is no data regarding the association between QT interval and left ventricular (LV) function and prognosis in patients with low LV ejection fraction (LVEF), low‐flow, low‐gradient aortic stenosis (LF‐LG AS). We aimed to examine the relationship between corrected QT interval (QTc) and LV function and outcome in these patients. Methods and Results Ninety‐three patients (73±10 years; 74% men) with LF‐LG AS (mean gradient <40 mm Hg and indexed aortic valve area ≤0.6 cm2/m2) and reduced LVEF (≤40%) were prospectively included in this analysis and 63 of them underwent aortic valve replacement within 3 months following inclusion. Prolonged QTc was defined as QTc >450 ms in men and >470 ms in women. LV global longitudinal strain was measured by speckle tracking and expressed in absolute value |%|. QTc correlated with the following: global longitudinal strain (r=−0.40, P=0.005), LVEF (r=−0.27, P=0.02), stroke volume (r=−0.35, P=0.007), and B‐type natriuretic peptide (r=0.45, P=0.0006). During a median follow‐up of 2.0 years, 49 patients died. Prolonged QTc was associated with a 2‐fold increase in all‐cause mortality (hazard ratio=2.05; P=0.01) and cardiovascular mortality (hazard ratio=1.89; P=0.04). In multivariable analysis adjusted for EuroSCORE, aortic valve replacement, previous myocardial infarction, LVEF, and ß‐blocker medication, prolonged QTc was independently associated with all‐cause mortality (hazard ratio=2.56; P=0.008) and cardiovascular mortality (hazard ratio=2.50; P=0.02). Conclusions In patients with LF‐LG AS and reduced LVEF, longer QTc interval was associated with worse LV function and increased risk of death. Assessment of QTc may provide a simple and inexpensive tool to enhance risk stratification in LF‐LG AS patients.
  • PublicationAccès libre
    Effect of age and aortic valve anatomy on calcification and haemodynamic severity of aortic stenosis
    (British Cardiac Society, 2016-12-09) Larose, Éric; Shen, Mylène; Chetaille, Philippe; Bédard, Élisabeth; Capoulade, Romain; Pibarot, Philippe; Dumesnil, Jean G.; Clavel, Marie-Annick; Tastet, Lionel; Mathieu, Patrick; Arsenault, Marie
    Objective: To evaluate the effect of age and aortic valve anatomy (tricuspid [TAV] versus bicuspid [BAV] aortic valve) on the relationship between the aortic valve calcification (AVC) and the hemodynamic parameters of aortic stenosis (AS) severity. Methods: Two hundred patients with AS and preserved left ventricular ejection fraction were prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study and underwent a comprehensive Doppler echocardiography and multidetector computed tomography (MDCT). Mean transvalvular gradient (MG) measured by Doppler echocardiography was used to assess AS hemodynamic severity and AVC was evaluated by MDCT using the Agatston method and indexed to the left ventricular outflow tract area to obtain AVC density (AVCd). All analyses were adjusted for sex. Results: Thirty-nine patients had a BAV and 161 a TAV. Median age was 51 and 72 years for BAV and TAV patients respectively. There was a modest correlation between MG and AVCd (ρ=0.51, p<0.0001) in the whole cohort. After dichotomization for valve anatomy, there was a good correlation between AVCd and MG in the TAV group (ρ=0.61, p<0.0001) but weak correlation in the BAV group (ρ=0.32, p=0.046). In the TAV group, the strength of the AVCd-MG correlation was similar in younger (<72 years old; ρ=0.59, p<0.0001) versus older (≥72 years old; ρ=0.61, p<0.0001) patients. In the BAV group, there was no correlation between AVCd and MG in younger patients (<51 years old; ρ=0.12, p=0.65), whereas there was a good correlation in older patients (≥51 years old; ρ=0.55, p=0.009). AVCd (p=0.005) and age (p=0.02) were both independent determinants of MG in BAV patients while AVCd (p<0.0001) was the only independent determinant of MG in TAV patients. Conclusion: In patients with TAV as well as in older patients with BAV, AVCd appears to be the main factor significantly associated with the hemodynamic severity of AS and so it may be used to corroborate AS severity in case of uncertain or discordant findings at echocardiography. However, among younger patients with BAV, some may have a hemodynamically significant stenosis with minimal AVCd. The results of MDCT AVCd should thus be interpreted cautiously in this subset of patients.
  • PublicationAccès libre
    Effect of regional upper septal hypertrophy on echocardiographic assessment of left ventricular mass and remodeling in aortic stenosis
    (ScienceDirect, 2020-10-14) Guzzetti, Ezequiel; Garcia, Julio; Larose, Éric; Shen, Mylène; Le Ven, Florent; Bédard, Élisabeth; Capoulade, Romain; Annabi, Mohamed Salah; Pibarot, Philippe; Clavel, Marie-Annick; Tastet, Lionel; Arsenault, Marie
    Background: Transthoracic echocardiography (TTE) is the reference method for evaluation of aortic stenosis (AS), and it is extensively used to quantitate left ventricular (LV) mass and volumes. Regional upper septal hypertrophy (USH) or septal bulge is a frequent finding in patients with AS and may lead to overestimation of LV mass when using linear measurements. The objective of this study was to compare estimates of LV mass obtained by two-dimensional transthoracic echocardiographic LV dimensions measured at different levels of the LV cavity with those obtained by cardiovascular magnetic resonance (CMR). Methods: One hundred six patients (mean age, 63 ± 15 years; 68% men) with AS were included in this subanalysis of the PROGRESSA study. Two-dimensional transthoracic echocardiographic measurements of LV dimensions were obtained at the basal level (BL; as recommended in guidelines), immediately below the septal bulge (BSB), and at a midventricular level (ML). Regional USH was defined as a basal interventricular septal thickness ≥ 13 mm and >1.3 times the thickness of the septal wall at the ML. Agreement between transthoracic echocardiographic and CMR measures was evaluated using Bland-Altman analysis. Results: The distribution of AS severity was mild in 23%, moderate in 57%, and severe in 20% of patients. Regional USH was present in 28 patients (26%). In the whole cohort, two-dimensional TTE overestimated LV mass (bias: BL, +60 ± 31 g; BSB, +59 ± 32 g; ML, +54 ± 32 g; P = .02). The biplane Simpson method slightly but significantly underestimated LV end-diastolic volume (bias -10 ± 20 mL, P < .001) compared with CMR. Overestimation of LV mass was more marked in patients with USH when measuring at the BL and was significantly lower when measuring LV dimensions at the ML (P < .025 vs BL and BSB). Conclusions: Two-dimensional TTE systematically overestimated LV mass and underestimated LV volumes compared with CMR. However, the bias between TTE and CMR was less important when measuring at the ML. Measurements at the BL as suggested in guidelines should be avoided, and measurements at the ML should be preferred in patients with AS, especially in those with USH.
  • PublicationAccès libre
    Accuracy of stroke volume measurement with phase-contrast cardiovascular magnetic resonance in patients with aortic stenosis
    (Marcel Dekker, 2021-11-04) Guzzetti, Ezequiel; Racine, Hugo-Pierre; Larose, Éric; Shen, Mylène; Beaudoin, Jonathan; Pibarot, Philippe; Clavel, Marie-Annick; Tastet, Lionel
    Background: Phase contrast (PC) cardiovascular magnetic resonance (CMR) in the ascending aorta (AAo) is widely used to calculate left ventricular (LV) stroke volume (SV). The accuracy of PC CMR may be altered by turbulent fow. Measurement of SV at another site is suggested in the presence of aortic stenosis, but very few data validates the accuracy or inaccuracy of PC in that setting. Our objective is to compare fow measurements obtained in the AAo and LV outfow tract (LVOT) in patients with aortic stenosis. Methods: Retrospective analysis of patients with aortic stenosis who had CMR and echocardiography. Patients with mitral regurgitation were excluded. PC in the AAo and LVOT were acquired to derive SV. LV SV from end-systolic and end-diastolic tracings was used as the reference measure. A diference≥10% between the volumetric method and PC derived SVs was considered discordant. Metrics of turbulence and jet eccentricity were assessed to explore the predictors of discordant measurements. Results: We included 88 patients, 41% with bicuspid aortic valve. LVOT SV was concordant with the volumetric method in 79 (90%) patients vs 52 (59%) patients for AAo SV (p=0.015). In multivariate analysis, aortic stenosis fow jet angle was a strong predictor of discordant measurement in the AAo (p=0.003). Mathematical correction for the jet angle improved the concordance from 59 to 91%. Concordance was comparable in patients with bicuspid and trileafet valves (57% and 62% concordance respectively; p=0.11). Accuracy of SV measured in the LVOT was not infuenced by jet eccentricity. For aortic regurgitation quantifcation, PC in the AAo had better correlation to volumetric assessments than LVOT PC. Conclusion: LVOT PC SV in patients with aortic stenosis and eccentric jet might be more accurate compared to the AAo SV. Mathematical correction for the jet angle in the AAo might be another alternative to improve accuracy.
  • PublicationRestreint
    Left ventricular asymmetric remodeling and subclinical left ventricular dysfunction in patients with calcific aortic valve stenosis : results from a subanalysis of the PROGRESSA study
    (Elsevier Science Publishers, 2021-03-13) Clisson, Marine; Guzzetti, Ezequiel; Bernard, Jérémy; Larose, Éric; Shen, Mylène; Bédard, Élisabeth; Côté, Nancy; Capoulade, Romain; Pibarot, Philippe; Clavel, Marie-Annick; Tastet, Lionel; Arsenault, Marie
    Background: LV asymmetric remodeling (LVAR) is a feature commonly found in AS patients and it is presumed to be mainly related to the severity of valve stenosis. The aim of this study was to determine the associated factors and impact on left ventricular (LV) systolic function of LVAR in patients with mild and moderate aortic valve stenosis (AS). Methods: Clinical, Doppler-echocardiographic and computed-tomographic data of 155 AS patients with preserved LV ejection fraction (≥50%) prospectively recruited in the PROGRESSA study (NCT01679431) were analyzed. LVAR was defined as a septal wall thickness ≥ 13 mm and a ratio of septal/posterior wall thickness > 1.5. LV global longitudinal strain (LV-GLS) was available in 129 patients. Plasma levels of N-terminal natriuretic B-type peptides (Nt-proBNP) were also measured. Results: Mean age was 63 ± 15 years (70% men). LVAR was present in 21% (n = 33) of patients. A series of nested multivariate analysis revealed that age was the only factor associated with LVAR (all p ≤ 0.03). Additionally, these patients had higher baseline Nt-proBNP ratio (median [25–75 percentiles]: 1.04 [0.66–2.41] vs. 0.65 [0.33–1.19], p = 0.02), and significantly reduced LV-GLS (17.9[16.6–19.5] vs. 19.3[17.4–20.7] |%|, p = 0.04). A 1:1 matched analysis showed a significant association of LVAR with reduced LV-GLS (17.9[16.6–19.5] vs. 19.8[18.1–20.7] |%|, p = 0.02) and elevated Nt-proBNP (134[86–348] vs. 83[50–179]pg/ml, p = 0.03). Multivariable analysis also revealed that LVAR remains significantly associated with reduced LV-GLS (p = 0.03) and elevated Nt-proBNP (p = 0.001). LVAR was significantly associated with increased risk of major adverse cardiac events and death (Hazard ratio [95% confidence interval]: 2.32[1.28–4.22], p = 0.006). Conclusions: LVAR was found in ~20% of patients with mild or moderate AS and was not related to the degree of AS severity or concomitant comorbidities, but rather to older age. LVAR was significantly associated with reduced LV longitudinal systolic function, increased Nt-proBNP levels, and higher risk of major adverse events and death. These findings provide support for closer clinical and echocardiographic surveillance of patients harboring this adverse LV remodeling feature.
  • PublicationRestreint
    Systolic hypertension and progression of aortic valve calcification in patients with aortic stenosis : results from the PROGRESSA study
    (Oxford University Press, 2016-02-18) Larose, Éric; Shen, Mylène; Capoulade, Romain; Bossé, Yohan; Pibarot, Philippe; Dumesnil, Jean G.; Tremblay, Alexe; Clavel, Marie-Annick; Després, Jean-Pierre; Tastet, Lionel
    Background : Systolic hypertension is one of the most frequent comorbidities encountered in patients with aortic stenosis (AS). In a recent study, we reported that systolic hypertension is associated with faster hemodynamic progression of AS and reduced survival. However, the impact of hypertension on the progression of aortic valve calcification (AVC), which is the culprit lesion of AS, is unknown. The main objective of this prospective study was to assess the impact of systolic hypertension on the progression of AVC in AS patients. Methods : One hundred and one patients with AS were prospectively recruited in the PROGRESSA study (NCT01679431). AVC and coronary artery calcification (CAC) were measured by multidetector computed tomography at baseline and at 2-year follow-up using the Agatston method. Results : The mean age was 65 ±13 years and 74% were male. During the 2-year follow-up, patients with systolic hypertension (i.e. systolic blood pressure =140 mmHg; n=37) at baseline had faster progression of AVC compared to those with no systolic hypertension (AVC: +370 [126-824] vs. +157 [58-303] AU; p=0.007; Figure). In multivariable analysis adjusted for age, sex, antihypertensive treatment, dyslipidemia, diabetes, metabolic syndrome, creatinine level, baseline hemodynamic AS severity, and baseline AVC, systolic hypertension remained an independent predictor of faster progression of AVC (p=0.001). In contrast, there was no significant difference in the progression of CAC between patients with versus without systolic hypertension (CAC: +39 [3-199] vs. +116 [28-189] AU; p=0.17; Figure). Conclusion : This prospective study shows that systolic hypertension is a powerful and independent predictor of faster progression of AVC but not of CAC in patients with AS. These findings emphasize the difference in the pathological processes leading to valvular versus vascular mineralization, and provide further to support the elaboration of randomized clinical trials targeting the treatment of hypertension in patients with AS
  • PublicationAccès libre
    Visceral adiposity and left ventricular mass and function in patients with aortic stenosis : the PROGRESSA study
    (Canadian Cardiovascular Society, 2014-02-01) Dahou, Abdellaziz; Larose, Éric; Le Ven, Florent; Larue-Grondin, Samuel; Bédard, Élisabeth; Capoulade, Romain; Pibarot, Philippe; Dumesnil, Jean G.; Clavel, Marie-Annick; Després, Jean-Pierre; Mathieu, Patrick; Arsenault, Marie
    Background : Recent studies have reported that obesity, metabolic syndrome, and diabetes are associated with left ventricular (LV) hypertrophy (LVH) and dysfunction in patients with aortic stenosis (AS). The purpose of this study was to examine the association between amount and distribution of body fat and LVH and systolic dysfunction in AS patients. Methods : One hundred twenty-four patients with AS were prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study and underwent Doppler echocardiography and computed tomography scan. Presence and severity of LVH was assessed according to LV mass indexed for height2.7 and LV dysfunction according to global longitudinal strain (GLS). Computed tomography was used to quantify abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue, and total adipose tissue (TAT). Results : Body mass index (BMI) correlated strongly with TAT (r = 0.85), moderately with VAT (r = 0.70), and SAT (r = 0.69), and weakly with the proportion of VAT (VAT/TAT ratio: r = 0.19). In univariate analysis, greater BMI, TAT, VAT, SAT, and VAT/TAT were associated with increased LV mass index and greater VAT and VAT/TAT ratio were associated with reduced GLS. Multivariate analysis revealed that larger BMI (P < 0.0001) and greater VAT/TAT ratio (P = 0.01) were independently associated with higher prevalence of LVH, and only the VAT/TAT ratio (P = 0.03) was independently associated with reduced GLS. Conclusions : The results of this study suggest that total and visceral adiposity are independently associated with LVH in patients with AS. Furthermore, impairment of LV systolic function does not appear to be influenced by total obesity but is rather related to excess visceral adiposity. These findings provide impetus for elaboration of interventional studies aiming at visceral adiposity in the AS population.
  • PublicationAccès libre
    Tricuspid regurgitation is associated with increased risk of mortality in patients with low-flow low-gradient aortic stenosis and reduced ejection fraction : results of the multicenter TOPAS study (true or pseudo-severe aortic stenosis)
    (Elsevier, 2015-04-20) Dahou, Abdellaziz; Sénéchal, Mario; Larose, Éric; Magne, Julien; Bartko, Philipp Emanuel; Rodés-Cabau, Josep; Bergler-Klein, Jutta; Capoulade, Romain; Pibarot, Philippe; Mundigler, Gerald; Dumesnil, Jean G.; Burwash, Ian; Clavel, Marie-Annick; Ribeiro, Henrique B.; O’Connor, Kim; Mathieu, Patrick; Baumgartner, Helmut; Rosenhek, Raphael
    Objectives : This study sought to examine the impact of tricuspid regurgitation (TR) on mortality in patients with low-flow, low-gradient (LF-LG) aortic stenosis (AS) and reduced left ventricular ejection fraction (LVEF). Background : TR is often observed in patients with LF-LG AS and low LVEF, but its impact on prognosis remains unknown. Methods : A total of 211 patients (73 ± 10 years of age; 77% men) with LF-LG AS (mean gradient <40 mm Hg and indexed aortic valve area [AVA] =0.6 cm2/m2) and reduced LVEF (=40%) were prospectively enrolled in the TOPAS (True or Pseudo-Severe Aortic Stenosis) study and 125 (59%) of them underwent aortic valve replacement (AVR) within 3 months following inclusion. The severity of AS was assessed by the projected AVA (AVAproj) at normal flow rate (250 ml/s), as previously described and validated. The severity of TR was graded according to current guidelines. Results : Among the 211 patients included in the study, 22 (10%) had no TR, 113 (54%) had mild (grade 1), 50 (24%) mild-to-moderate (grade 2), and 26 (12%) moderate-to-severe (grade 3) or severe (grade 4) TR. During a mean follow-up of 2.4 ± 2.2 years, 104 patients (49%) died. Univariable analysis showed that TR =2 was associated with increased risk of all-cause mortality (hazard ratio [HR]: 1.82, 95% confidence interval [CI]: 1.22 to 2.71; p = 0.004) and cardiovascular mortality (HR: 1.85, 95% CI: 1.20 to 2.83; p = 0.005). After adjustment for age, sex, coronary artery disease, AVAproj, LVEF, stroke volume index, right ventricular dysfunction, mitral regurgitation, and type of treatment (AVR vs. conservative), the presence of TR =2 was an independent predictor of all-cause mortality (HR: 1.88, 95% CI: 1.08 to 3.23; p = 0.02) and cardiovascular mortality (HR: 1.92, 95% CI: 1.05 to 3.51; p = 0.03). Furthermore, in patients undergoing AVR, TR =3 was an independent predictor of 30-day mortality compared with TR = 0/1 (odds ratio [OR]: 7.24, 95% CI: 1.56 to 38.2; p = 0.01) and TR = 2 (OR: 4.70, 95% CI: 1.00 to 25.90; p = 0.05). Conclusions : In patients with LF-LG AS and reduced LVEF, TR is independently associated with increased risk of cumulative all-cause mortality and cardiovascular mortality regardless of the type of treatment. In patients undergoing AVR, moderate/severe TR is associated with increased 30-day mortality. Further studies are needed to determine whether TR is a risk marker or a risk factor of mortality and whether concomitant surgical correction of TR at the time of AVR might improve outcomes for this high-risk population.
  • PublicationRestreint
    Discrepancies between cardiovascular magnetic resonance and Doppler echocardiography in the measurement of transvalvular gradient in aortic stenosis : the effect of flow vorticity.
    (M. Dekker, 2013-09-20) Garcia, Julio; Larose, Éric; Le Ven, Florent; Gaillard, Emmanuel; Kadem, Lyes; Capoulade, Romain; Pibarot, Philippe
    BACKGROUND: Valve effective orifice area EOA and transvalvular mean pressure gradient (MPG) are the most frequently used parameters to assess aortic stenosis (AS) severity. However, MPG measured by cardiovascular magnetic resonance (CMR) may differ from the one measured by transthoracic Doppler-echocardiography (TTE). The objectives of this study were: 1) to identify the factors responsible for the MPG measurement discrepancies by CMR versus TTE in AS patients; 2) to investigate the effect of flow vorticity on AS severity assessment by CMR; and 3) to evaluate two models reconciling MPG discrepancies between CMR/TTE measurements. METHODS: Eight healthy subjects and 60 patients with AS underwent TTE and CMR. Strouhal number (St), energy loss (EL), and vorticity were computed from CMR. Two correction models were evaluated: 1) based on the Gorlin equation (MPG(CMR-Gorlin)); 2) based on a multivariate regression model (MPG(CMR-Predicted)). RESULTS: MPGCMR underestimated MPGTTE (bias = -6.5 mmHg, limits of agreement from -18.3 to 5.2 mmHg). On multivariate regression analysis, St (p = 0.002), EL (p = 0.001), and mean systolic vorticity (p < 0.001) were independently associated with larger MPG discrepancies between CMR and TTE. MPG(CMR-Gorlin) and MPGTTE correlation and agreement were r = 0.7; bias = -2.8 mmHg, limits of agreement from -18.4 to 12.9 mmHg. MPG(CMR-Predicted) model showed better correlation and agreement with MPGTTE (r = 0.82; bias = 0.5 mmHg, limits of agreement from -9.1 to 10.2 mmHg) than measured MPGCMR and MPG(CMR-Gorlin). CONCLUSION: Flow vorticity is one of the main factors responsible for MPG discrepancies between CMR and TTE.