Quantification of Mitral Regurgitation

Mitral regurgitation (MR) is the most common valvular disease in the developed world and is expected to increase with the aging population. Primary MR is caused by an intrinsic valve abnormality (usually mitral valve prolapse), whereas secondary (functional) MR occurs in the setting of left ventricular (LV) remodeling, mitral annular dilatation, or both. Transthoracic echocardiography (TTE) with Doppler is the initial recommended modality for MR evaluation. The use of alternative imaging modalities such as transesophageal echocardiography or cardiac magnetic resonance imaging is typically reserved when the grade of MR is unclear or discrepancy between TTE findings and clinical scenario exist. In this chapter, we discuss the recommended methods for quantification of MR based on the most recent American Society of Echocardiography guidelines.