However, echocardiographic methods have their limitations as they are based on many geometric assumptions, resulting in less accurate quantification of LV function and MR severity. In most instances, the use of 2D and Doppler echocardiographic protocols are sufficient. Echocardiography, which includes both transthoracic (TTE) and transesophageal (TOE) approaches, has been the cornerstone of assessing MR, providing anatomical and functional information. The comprehensive assessment of MR requires evaluation of MV anatomy, MR severity, LV size and systolic function, and assessment of associated features such as pulmonary arterial hypertension. This review examines the role and limitations of contemporary non-invasive imaging modalities for the assessment of patients with MR. Recent innovations in non-invasive imaging have provided insights into the quantification of MR, early detection of LV dysfunction, and advanced prognostic assessment these are potentially additional factors for determining surgical timing in asymptomatic MR. Traditionally, imaging has focused on assessing mitral valve (MV) morphology, hemodynamic severity, ventricular remodelling and suitability for surgical intervention. Accurate assessment of MR severity and its complications are important, as it not only determines timing and indication for surgical correction, but also carries significant prognostic implications ( 3, 6). Patients referred to surgical centres for severe MR, based on echocardiography findings, are often found to have only mild or moderate MR on quantitative evaluation ( 5). The degree of MR is defined by the lesion severity and the resulting volume overload ( 4). Although some patients may remain asymptomatic, severe MR eventually leads to left ventricular (LV) failure, pulmonary hypertension, atrial fibrillation and death ( 3). Mitral regurgitation (MR) is the second most frequent valve disease in Europe after aortic valve stenosis ( 1, 2). Keywords: Cardiovascular magnetic resonance (CMR) echocardiography mitral regurgitation (MR) mitral valve disease (MV disease) Integration of multimodality imaging for the assessment of MR utilises the advantages of each imaging technique and offers the most comprehensive assessment of MR. Whilst advanced echocardiographic techniques are superior in the evaluation of complex MV anatomy, CMR appears the most accurate technique for the quantification of MR severity. This review summarises the current evidence for state-of-the-art cardiovascular imaging for the investigation of MR. Other techniques such as exercise echocardiography, tissue Doppler imaging and speckle-tracking echocardiography can further offer complementary information on prognosis. Cardiovascular magnetic resonance (CMR) is increasingly used for MR quantitation and can provide an alternative imaging method if echocardiography is suboptimal or inconclusive. However, the advance from 2D to 3D imaging leads to improved assessment and characterization of mitral valve (MV) disease. Transthoracic (TTE) and transesophageal (TOE) echocardiography are the mainstay for diagnosis, assessment and serial surveillance. Innovations in non-invasive imaging have provided new insights into the pathophysiology and quantification of MR, in addition to early detection of left ventricular (LV) dysfunction and prognostic assessment in asymptomatic patients. Policy of Dealing with Allegations of Research MisconductĪbstract: The natural history of mitral regurgitation (MR) results in significant morbidity and mortality.Policy of Screening for Plagiarism Process.
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