{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:07:49Z","timestamp":1790708869145,"version":"4.1.0"},"reference-count":60,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Quantification of chronic mitral regurgitation (MR) is essential to guide patients\u2019 clinical management and define the need and appropriate timing for mitral valve surgery. Echocardiography represents the first-line imaging modality to assess MR and requires an integrative approach based on qualitative, semiquantitative, and quantitative parameters. Of note, quantitative parameters, such as the echocardiographic effective regurgitant orifice area, regurgitant volume (RegV), and regurgitant fraction (RegF), are considered the most reliable indicators of MR severity. In contrast, cardiac magnetic resonance (CMR) has demonstrated high accuracy and good reproducibility in quantifying MR, especially in cases with secondary MR; nonholosystolic, eccentric, and multiple jets; or noncircular regurgitant orifices, where quantification with echocardiography is an issue. No gold standard for MR quantification by noninvasive cardiac imaging has been defined so far. Only a moderate agreement has been shown between echocardiography, either with transthoracic or transesophageal approaches, and CMR in MR quantification, as supported by numerous comparative studies. A higher agreement is evidenced when echocardiographic 3D techniques are used. CMR is superior to echocardiography in the calculation of the RegV, RegF, and ventricular volumes and can provide myocardial tissue characterization. However, echocardiography remains fundamental in the pre-operative anatomical evaluation of the mitral valve and of the subvalvular apparatus. The aim of this review is to explore the accuracy of MR quantification provided by echocardiography and CMR in a head-to-head comparison between the two techniques, with insight into the technical aspects of each imaging modality.<\/jats:p>","DOI":"10.3390\/jcdd10040150","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T08:27:27Z","timestamp":1680251247000},"page":"150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Echocardiography vs. CMR in the Quantification of Chronic Mitral Regurgitation: A Happy Marriage or Stormy Divorce?"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2093-3671","authenticated-orcid":false,"given":"Francesca","family":"Baessato","sequence":"first","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, 80636 Munich, Germany"},{"name":"Department of Cardiology, Regional Hospital S. Maurizio, 39100 Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0309-6231","authenticated-orcid":false,"given":"Laura","family":"Fusini","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"},{"name":"Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, 20133 Milan, Italy"},{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Muratori","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Tamborini","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ghulam Ali","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0696-1625","authenticated-orcid":false,"given":"Valentina","family":"Mantegazza","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8261-4529","authenticated-orcid":false,"given":"Andrea","family":"Baggiano","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saima","family":"Mushtaq","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Pepi","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5404-3968","authenticated-orcid":false,"given":"Giuseppe","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"},{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1339-6679","authenticated-orcid":false,"given":"Gianluca","family":"Pontone","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 2012 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1161\/CIRCULATIONAHA.119.041080","article-title":"Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey","volume":"140","author":"Iung","year":"2019","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1016\/S0140-6736(09)60692-9","article-title":"Mitral regurgitation","volume":"373","author":"Akins","year":"2009","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/ehjci\/jey147","article-title":"The evolving role of cardiac magnetic resonance in primary mitral regurgitation: Ready for prime time?","volume":"20","author":"Liu","year":"2019","journal-title":"Eur. 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