The Role of Cardiac Imaging for the Evaluation of Primary and Secondary Mitral Regurgitation: From Milestones to Novelties.

Abstract

Mitral regurgitation (MR) is the second most prevalent valvular heart disease, classified as primary (degenerative) or secondary (functional) based on its underlying etiology. Accurate assessment of MR severity, mechanism, and prognosis is crucial for guiding therapeutic decision-making, including surgical and transcatheter interventions. Cardiac imaging plays a pivotal role in this evaluation, wherein transthoracic and transesophageal echocardiography is considered the first-line modality. Advancements in three-dimensional echocardiography and cardiac magnetic resonance imaging allowed to refine the quantification and characterization of MR, enhancing diagnostic accuracy and risk stratification. This review aims to provide an overview of multimodal cardiac imaging and the most relevant parameters to assess MR, highlighting key milestones, novel techniques, and their implications in clinical practice.