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Regurgitant fraction (RF) can also be estimated by Doppler examination of the left subclavian artery (LSA-Doppler). However, a comparison of AR grading scales using these methods and a TTE multiparametric approach as reference is lacking. We evaluated the severity of AR in 73 patients (58\u2009\u00b1\u200915\u00a0years; 57 men), with a wide spectrum of AR of the native valve. Using a recommended TTE multiparametric approach the AR was divided in none\/trace (n\u2009=\u200912), mild (n\u2009=\u200923), moderate (n\u2009=\u200912), and severe (n\u2009=\u200926). RF was evaluated by LSA-Doppler (ratio between diastolic and systolic velocity\u2013time integrals) and by CMR phase-contrast imaging (performed in the aorta 1\u00a0cm above the aortic valve); the grading scales were then calculated. There were a good correlation between all methods, but mean RF values were greater with TTE compared with LSA-Doppler and CMR (39\u2009\u00b1\u200916% vs. 35\u2009\u00b1\u200918% vs. 32\u2009\u00b1\u200920%, respectively; p\u2009&lt;\u20090.037). Mean differences in RF values between methods were significant in the groups with mild and moderate AR. Grading scales that best defined the TTE derived AR severity using CMR were: mild, &lt;\u200921%; moderate, 22 to 41%; and severe, &gt;\u200942%; and using LSA-Doppler: mild, &lt;\u200929%; moderate, 30 to 44%; and severe, &gt;\u200945%. RF values for AR grading using TTE, LSA-Doppler and CMR correlate well but differ in groups with mild and moderate AR when using a recognized multiparametric echocardiographic approach. Clinical prospective studies should validate these proposed modality adjusted grading scales.<\/jats:p>","DOI":"10.1007\/s10554-020-01844-2","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T05:02:47Z","timestamp":1587186167000},"page":"1517-1526","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Grading of aortic regurgitation by cardiovascular magnetic resonance and pulsed Doppler of the left subclavian artery: harmonizing grading scales between imaging modalities"],"prefix":"10.1007","volume":"36","author":[{"given":"Ricardo A.","family":"Spampinato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosima","family":"Jahnke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Paetsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Hilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"L\u00f6be","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Lindemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfriede","family":"Strotdrees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Hindricks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Borger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,18]]},"reference":[{"issue":"2","key":"1844_CR1","first-page":"155","volume":"75","author":"C Veyrat","year":"1982","unstructured":"Veyrat C, Ollagnier J, Kalmanson D, Tabet J, Laaban J, Philippe B, Savier CH, Chiche P (1982) Diagnosis and evaluation of aortic insufficiency by continuous Doppler velocimetry of the subclavian artery. 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