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Quantitation of mitral regurgitation with cardiac magnetic resonance imaging: a systematic review
  1. Eric V Krieger1,2,
  2. James Lee1,
  3. Kelley R Branch1,
  4. Christian Hamilton-Craig1,3,4
  1. 1Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
  2. 2Seattle Adult Congenital Heart Service, University of Washington School of Medicine, Seattle, Washington, USA
  3. 3Department of Cardiology, University of Queensland, Brisbane, Queensland, Australia
  4. 4Department of Cardiology, Heart & Lung Institute, The Prince Charles Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Dr Eric V Krieger, Seattle Adult Congenital Heart Service, University of Washington School of Medicine, Seattle, WA 98195, USA; ekrieger{at}


In this review discuss the application of cardiac magnetic resonance (CMR) to the evaluation and quantification of mitral regurgitation and provide a systematic literature review for comparisons with echocardiography. Using the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, we searched Medline and PubMed for original research articles published since 2000 that provided data on the quantification of mitral regurgitation by CMR. We identified 220 articles of which 33 were included. Four main techniques of mitral regurgitation quantification were identified. Reproducibility varied substantially between papers but was high overall for all techniques. However, quantification differed between the techniques studied. When compared with two-dimensional echocardiography, mitral regurgitation fraction and regurgitant volume measured by CMR were comparable but typically lower. CMR has high reproducibility for the quantification of mitral regurgitation in experienced centres, but further technological refinement is needed. An integrated and standardised approach that combines multiple techniques is recommended for optimal reproducibility and precise mitral regurgitation quantification. Definitive outcome studies using CMR as a basis for treatment are lacking but needed.

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  • Contributors EVK: drafting of manuscript, creation of figures, critical review and final approval. JL: drafting of manuscript and final approval. KRB and CH-C: drafting of manuscript, critical review and final approval.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.