Standard and emerging CMR methods for mitral regurgitation quantification

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Quantitative Analysis

Background:

• Several cardiovascular magnetic resonance (CMR) techniques exist for quantifying mitral regurgitation (MR).
• The interoperability and reproducibility of these MR quantification methods are not well-established.
• Understanding method agreement is crucial for accurate clinical assessment.

Purpose of the Study:

• To evaluate the agreement and reproducibility of different MR quantification methods using CMR.
• To compare four distinct MR quantification techniques across various etiologies of MR.
• To identify the most reliable method for MR quantification via CMR.

Main Methods:

• Thirty-five patients with primary MR, secondary MR, or mitral valve repair (MVR) were included.
• CMR imaging, including cines and 4D flow, was performed.
• Four quantification methods were assessed: MR_Standard, MR_LVRV, MR_Jet, and MR_MVAV, with intra- and inter-observer variability analyzed.

Main Results:

• MR_MVAV and MR_LVRV were comparable to MR_Standard in primary MR; MR_Jet yielded significantly higher volumes.
• All methods showed comparability in secondary MR and MVR cases.
• MR_MVAV exhibited the least bias and highest concordance correlation coefficient (CCC) in intra- and inter-observer tests.

Conclusions:

• CMR quantification methods for MR show agreement in secondary MR and MVR, but not in primary MR.
• MR_MVAV quantification demonstrated superior reproducibility and consistency across all evaluated MR types.
• The findings suggest MR_MVAV as a reliable method for MR quantification using CMR.