Standard and emerging CMR methods for mitral regurgitation quantification.
Fidock B., Archer G., Barker N., Elhawaz A., Al-Mohammad A., Rothman A., Hose R., Hall IR., Grech E., Briffa N., Lewis N., van der Geest RJ., Zhang J-M., Zhong L., Swift AJ., Wild JM., De Gárate E., Bucciarelli-Ducci C., Bax JJ., Plein S., Myerson S., Garg P.
BACKGROUND: There are several methods to quantify mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR). The interoperability of these methods and their reproducibility remains undetermined. OBJECTIVE: To determine the agreement and reproducibility of different MR quantification methods by CMR across all aetiologies. METHODS: Thirty-five patients with MR were recruited (primary MR = 12, secondary MR = 10 and MVR = 13). Patients underwent CMR, including cines and four-dimensional flow (4D flow). Four methods were evaluated: MRStandard (left ventricular stroke volume - aortic forward flow by phase contrast), MRLVRV (left ventricular stroke volume - right ventricular stroke volume), MRJet (direct jet quantification by 4D flow) and MRMVAV (mitral forward flow by 4D flow - aortic forward flow by 4D flow). For all cases and MR types, 520 MR volumes were recorded by these 4 methods for intra-/inter-observer tests. RESULTS: In primary MR, MRMVAV and MRLVRV were comparable to MRStandard (P > 0.05). MRJet resulted in significantly higher MR volumes when compared to MRStandard (P