When should cardiac MRI be obtained alongside standard echocardiography for outpatient monitoring of the progression of chronic aortic regurgitation?

Aortic regurgitation impacts left ventricle with pressure and volume overload. In a patient with chronic, particularly moderate to severe or severe aortic regurgitation, the drop in left ventricular ejection fraction, increasing left ventricular dilation, and patient developing symptoms dictate the time to intervention.

If the echocardiogram is diagnostic quality, particularly with use of contrast echo, TTE is a reliable method to quantify LV volumes and EF. In cases where echo is technically difficult with poor windows, cardiac MRI can be used for the evaluation of aortic regurgitation and its impact on the LV. In select cases where the AI jets are eccentric, TEE or MRI can help further evaluate. Institutional expertise and physician prefe...