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August 15, 2026Journal of the American College of Cardiology135 citationsOpen Access

Use of Cardiac Magnetic Resonance Imaging in Assessing Mitral Regurgitation

SUSeth UretskyMorristown Medical CenterEAEdgar ArgulianMount Sinai Hospital
Jagat Narula
Jagat NarulaCardiac Imaging

Key Result

Cardiac magnetic resonance imaging accurately and reproducibly quantifies mitral regurgitation without regard to regurgitant jet morphology or the need for intravenous contrast.

Key Points

  • To review the utility, accuracy, and clinical relevance of cardiac magnetic resonance (CMR) imaging in the quantification and management of mitral regurgitation.
  • Evaluated CMR protocols utilizing steady state free precession and phase contrast imaging to determine regurgitant volume.
  • Calculated mitral regurgitant volume as the difference between left ventricular stroke volume and forward stroke volume without intravenous contrast.
  • CMR provides highly reproducible quantification of regurgitant volume regardless of jet complexity, including multiple or eccentric regurgitant jets.
  • The technique effectively assesses regurgitation in patients with multivalvular disease and intracardiac shunts while linking measurements to clinical outcomes.

Structured PICO

P
Population
Patients with mitral regurgitation
E
Exposure
Cardiac magnetic resonance imaging (CMR) using steady state free precession and phase contrast imaging

CMR provides an accurate and reproducible method for quantifying mitral regurgitant volume, independent of jet morphology.

Abstract

Accurate quantification of regurgitant volume is a central component to the management of mitral regurgitation. Cardiac magnetic resonance imaging (CMR) accurately quantifies mitral regurgitation as the difference between left ventricular stroke volume and forward stroke volume using steady state free precession and phase contrast imaging. The CMR measurement of mitral regurgitant volume is reproducible and can quantify mitral regurgitation in patients without regard to regurgitant jet morphology, such as patients with multiple and eccentric jets. It can be used to quantify regurgitant volume in patients with multiple valve lesions and concomitant intracardiac shunts without the use of intravenous contrast. Studies have highlighted the accuracy and reproducibility of CMR in quantifying mitral regurgitation and have begun to link CMR to clinical outcomes.

Expert Takes1 quote

“We felt that there is a building literature supporting the use of MRI in patients with mitral regurgitation and there wasn't a source that reviewed how best to do it and also reviewed the existing literature.”

Seth Uretsky, Medical director, cardiovascular imaging, Atlantic Health SystemAtlantic Health Systemauto_pipelineSupportiveView source
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Cite This Study

Uretsky et al. (2018) conducted a review in Mitral regurgitation. Cardiac magnetic resonance imaging (CMR) was evaluated. Cardiac magnetic resonance imaging accurately and reproducibly quantifies mitral regurgitation without regard to regurgitant jet morphology or the need for intravenous contrast.

synapsesocial.com/papers/6a7fdaa5fcbf2b1afafe78d5https://doi.org/10.1016/j.jacc.2017.12.009
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