EACVI survey on the evaluation of mitral regurgitation.

AIMS:To evaluate the diagnosis and imaging of patients with mitral regurgitation and the management in routine clinical practice across Europe, the EACVI Scientific Initiatives Committee performed a survey across European centres. In particular, the routine use of echocardiography, advanced imaging modalities, heart valve clinics and heart valve teams was explored. METHODS AND RESULTS:A total of 61 responders, mainly tertiary centres or university hospitals, from 26 different countries responded to the survey, which consisted of 22 questions. For most questions related to echocardiography and advanced imaging, the answers were relatively homogeneous and demonstrated good adherence to current recommendations. In particular, the centres used a multiparametric echocardiographic approach, and selected the effective regurgitant orifice and vena contracta width as their preferred assessments. Two-dimensional (2D) measurements are still the most widely used parameters to assess left ventricular structure, however the majority use three-dimensional (3D) trans-oesophageal echocardiography (TOE) to evaluate valve morphology in severe MR. The majority of centres reported the onsite availability and clinical use of ergometric stress echocardiography, cardiac computed tomography (CCT) and cardiac magnetic resonance imaging (CMR). Heart valve clinics and heart valve teams were also widely prevalent. CONCLUSION:Consistent with current guidelines echocardiography (TTE and TOE) remains the first line and central imaging modality for the assessment of mitral regurgitation although the complementary use of 3D TOE, CT and CMR appears to be growing. Heart valve clinics and heart valve teams are now widely prevalent.