{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T21:56:28Z","timestamp":1780350988072,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Four\u2010dimensional\u2010flow cardiac MR (4DF\u2010MR) offers advantages in primary mitral regurgitation. The relationship between 4DF\u2010MR\u2010derived mitral regurgitant volume (MR\u2010Rvol) and the post\u2010operative left ventricular (LV) reverse remodeling has not yet been established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To ascertain if the 4DF\u2010MR\u2010derived MR\u2010Rvol correlates with the LV reverse remodeling in primary mitral regurgitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective, single\u2010center, two arm, interventional vs. nonintervention observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Forty\u2010four patients (male N\u2009=\u200930; median age 68 [59\u201375]) with at least moderate primary mitral regurgitation; either awaiting mitral valve surgery (repair [MVr], replacement [MVR]) or undergoing \u201cwatchful waiting\u201d (WW).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>5\u2009T\/Balanced steady\u2010state free precession (bSSFP) sequence\/Phase contrast imaging\/Multishot echo\u2010planar imaging pulse sequence (five shots).<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Patients underwent transthoracic echocardiography (TTE), phase\u2010contrast MR (PMRI), 4DF\u2010MR and 6\u2010minute walk test (6MWT) at baseline, and a follow\u2010up PMRI and 6MWT at 6\u2009months. MR\u2010Rvol was quantified by PMRI, 4DF\u2010MR, and TTE by one observer. The pre\u2010operative MR\u2010Rvol was correlated with the post\u2010operative decrease in the LV end\u2010diastolic volume index (LVEDVi).<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Included Student <jats:italic>t<\/jats:italic>\u2010test\/Mann\u2013Whitney test\/Fisher's exact test, Bland\u2013Altman plots, linear regression analysis and receiver operating characteristic curves. Statistical significance was defined as <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While Bland\u2013Altman plots demonstrated similar bias between all the modalities, the limits of agreement were narrower between 4DF\u2010MR and PMRI (bias 15; limits of agreement \u221236\u2009mL to 65\u2009mL), than between 4DF\u2010MR and TTE (bias \u22128; limits of agreement \u2212106\u2009mL to 90\u2009mL) and PMRI and TTE (bias \u221223; limits of agreement \u2212105\u2009mL to 59\u2009mL). Linear regression analysis demonstrated a significant association between the MR\u2010Rvol and the post\u2010operative decrease in the LVEDVi, when the MR\u2010Rvol was quantified by PMRI and 4DF\u2010MR, but not by TTE (<jats:italic>P<\/jats:italic>\u2009=\u20090.73). 4DF\u2010MR demonstrated the best diagnostic performance for reduction in the post\u2010operative LVEDVi with the largest area under the curve (4DF\u2010MR 0.83; vs. PMRI 0.78; and TTE 0.51; <jats:italic>P<\/jats:italic>\u2009=\u20090.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>This study demonstrates the potential clinical utility of 4DF\u2010MR in the assessment of primary mitral regurgitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>2<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 5<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29284","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T10:39:14Z","timestamp":1707734354000},"page":"2378-2392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["4D Flow Cardiac MR in Primary Mitral Regurgitation"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5688-8980","authenticated-orcid":false,"given":"Miroslawa","family":"Gorecka","sequence":"first","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Cole","sequence":"additional","affiliation":[{"name":"Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1282-2859","authenticated-orcid":false,"given":"Malenka 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