Table 1 List of inclusion and exclusion criteria

Age > 16 or <65 years

Age ≤ 16 or ≥ 65 years

≥Moderate AR defined by > 1 of:

• Regurgitant fraction > 30%

• Regurgitant volume > 30mls

• Vena contracta width ≥ 0.3 cm

• Pressure half time ≤ 500ms

• Descending aorta end-diastolic velocity ≥ 20 cm/s

• Dense jet width CW

• Large jet width colour flow

• Diastolic flow reversal in descending aorta (intermediate or prominent holodiastolic)

• Large flow convergence colour flow

When ≤ 1 of the above criteria not met, severity assessed by ≥ 2 experienced sonographers/echocardiologists

>Mild aortic stenosis

>Mild mitral regurgitation

>Mild tricuspid regurgitation

Sinus rhythm

Atrial fibrillation

Completed exercise questionnaire

Known concomitant cardiomyopathy (including dilated or hypertrophic cardiomyopathy)

Ischaemic heart disease with previous MI or PCI

History of BAV endocarditis

Previous cardiac surgery

Previous cardiac surgery

Poor imaging quality