Mitral regurgitation cardiac MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Cardiac magnetic resonance (CMR) may be beneficial to evaluate the structure and function of the left atrium and left ventricle as well as the severity of the mitral regurgitation when echocardiography findings are inconclusive.

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Recommendations for Diagnostic Testing: Initial Diagnosis of Chronic MR Referenced studies that support the recommendations are summarized in Online Data Supplement

Class I

3.   In patients with primary MR, CMR is indicated to assess LV and RV volumes and function and may help with assessing MR severity when there is a discrepancy between the findings on clinical assessment and echocardiography (Level of Evidence: B-NR)

Recommendations for Diagnosis of Secondary MR Referenced studies that support the recommendations are summarized in Online Data Supplement

Class I

2.   In patients with chronic secondary MR (Stages B to D), noninvasive imaging (stress nuclear/PET, CMR, or stress echocardiography), coronary CT angiography, or coronary arteriography is useful to establish etiology of MR and to assess myocardial viability.(Level of Evidence: C-EO)

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary

Cardiac magnetic resonance (CMR) may be beneficial to evaluate the structure and function of the left atrium and left ventricle as well as the severity of the mitral regurgitation when echocardiography findings are inconclusive.

Recommendations for Chronic Primary Mitral Regurgitation

Class I

"1.Cardiac magnetic resonance (CMR) is indicated in patients with chronic primary MR to assess left ventricle and right ventricle volumes, function, or MR severity and when these issues are not satisfactorily addressed by TTE. (Level of Evidence: B)"

Recommendations for Chronic Secondary Mitral Regurgitation

Class I

"1.Noninvasive imaging (stress nuclear/positron emission tomography, CMR, or stress echocardiography), cardiac CT angiography, or cardiac catheterization, including coronary arteriography, is useful to establish etiology of chronic secondary MR (stages B to D) and/or to assess myocardial viability, which in turn may influence management of functional MR. (Level of Evidence: C)"

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

“

CMR may be used for assessing individuals with valvular heart disease in which evaluation of valvular stenosis, regurgitation, para- or perivalvular masses, perivalvular complications of infectious processes, or prosthetic valve disease are needed. CMR may be useful in identifying serial changes in LV volumes or mass in patients with valvular dysfunction.

”