Table 1

Tools for Mitral Regurgitation Quantification

ModalitySuggested Order of Use
VC3DE—VC area1
2DE—VC width2
CMR—VC width or area3
RVol/RFCMR—multiple methods1
3DE + 2DE—LV SV by endocardial contouring; aortic SV by 2DE or 3DE2
2DE—quantitative Doppler method3
3DE—novel color Doppler method
EROA3DE—PISA1
2DE—PISA2
2DE—volumetric method3
AROA§3DE—AROA1
CMR—AROA1
CT—AROA2

2DE = 2-dimensional echocardiography; CT = computed tomography; EROA = effective regurgitant orifice area; RF = regurgitant fraction; RVol = regurgitant volume; SV = stroke volume; VC = vena contracta.

  • Preferred method is difference between left ventricular (LV) endocardial contouring and aortic phase-contrast imaging.

  • Needs further validation before clinical use.

  • Ideally should use a method of 3-dimensional (3D) reconstruction of the proximal isovelocity surface area (PISA).

  • § 3D Echocardiography (3DE) and cardiac magnetic resonance (CMR) anatomic regurgitant orifice area (AROA) measurements should only be used if the regurgitant orifice is expected to be large (i.e., moderate or severe mitral regurgitation).