{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:57:37Z","timestamp":1785455857131,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Accurate echocardiographic assessment of chronic aortic regurgitation (AR) is challenging and subject to interobserver variability. We aim to evaluate reproducibility of guideline\u2010recommended echocardiographic parameters in real\u2010world practice and to assess cardiac magnetic resonance (CMR) as a complementary modality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 99 patients referred to us for transthoracic echocardiography (TTE) for AR evaluation. A subset of 22 patients also underwent CMR. AR severity was independently graded according to ESC and ASE guidelines by two expert cardiologists and two trainees using semi\u2010quantitative and quantitative parameters: pressure half\u2010time (PHT), vena contracta width (VCW), and PISA\u2010derived parameters, such as regurgitant orifice area (EROA). Interobserver agreement was analyzed using Cohen's Kappa, Bland\u2013Altman analysis, and intraclass correlation coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      VCW showed the highest reproducibility (overall\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u00a0=\u00a00.77), strong agreement across groups (EXACT team\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.7, TRAIN team\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u00a0=\u00a00.86), and high feasibility (68.7%). PHT demonstrated poor interobserver consistency (overall\n                      <jats:italic>\u03ba\u00a0=\u00a0<\/jats:italic>\n                      0.36), wide intra\u2010team variability (EXACT team\n                      <jats:italic>\u03ba\u00a0=\u00a0<\/jats:italic>\n                      0.30\u00a0vs. TRAIN team\n                      <jats:italic>\u03ba\u00a0=\u00a0<\/jats:italic>\n                      0.39), and high feasibility (77.8%). EROA showed moderate agreement (overall\n                      <jats:italic>\u03ba\u00a0=\u00a0<\/jats:italic>\n                      0.55, EXACT team\n                      <jats:italic>\u03ba\u00a0=\u00a0<\/jats:italic>\n                      0.64, TRAIN team\n                      <jats:italic>\u03ba\u00a0=\u00a0<\/jats:italic>\n                      0.74) and low feasibility (30.3%). CMR\u2010derived parameters (forward flow, backflow, and regurgitant fraction) displayed excellent reproducibility even between novice and expert readers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VCW is the most reliable echocardiographic parameter for AR assessment, while PHT and EROA are limited by variability and feasibility, respectively. Given its reproducibility and independence from operator expertise, CMR should be considered early when TTE findings are inconclusive. A simplified TTE\u2010first approach, followed by timely CMR, may optimize staging and management of chronic AR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70336","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T16:35:26Z","timestamp":1762446926000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic COncordance in Aortic Regurgitation Severity AssessMent: A ComPARative Study Between Cardiologists With Different Level of Expertise, the COMPARE\u2010AR Study"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2756-6405","authenticated-orcid":false,"given":"Giacomo Maria","family":"Viani","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hekuran","family":"Bytyci","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Viccaro","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Caretta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Landi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7580-8029","authenticated-orcid":false,"given":"Andrea","family":"Milzi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8186-9717","authenticated-orcid":false,"given":"Luca","family":"Bergamaschi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum, University of Bologna  Bologna Italy"},{"name":"Cardiovascular Division Morgagni\u2010Pierantoni University Hospital  Forl\u00ec Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne Anna","family":"Schlossbauer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2652-5927","authenticated-orcid":false,"given":"Laura Anna","family":"Leo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pedrazzini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale  Lugano Switzerland"},{"name":"Faculty of Biomedical Sciences Universit\u00e0 Della Svizzera Italiana  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4048-675X","authenticated-orcid":false,"given":"Carmine","family":"Pizzi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum, University of 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