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The assessment of mitral valve disease: a guideline from the British Society of Echocardiography

Echo Research & Practice volume 8, pages G87–G136 (2021)Cite this article

Abstract

Mitral valve disease is common. Mitral regurgitation is the second most frequent indication for valve surgery in Europe and despite the decline of rheumatic fever in Western societies, mitral stenosis of any aetiology is a regular finding in all echo departments. Mitral valve disease is, therefore, one of the most common pathologies encountered by echocardiographers, as both a primary indication for echocardiography and a secondary finding when investigating other cardiovascular disease processes. Transthoracic, transoesophageal and exercise stress echocardiography play a crucial role in the assessment of mitral valve disease and are essential to identifying the aetiology, mechanism and severity of disease, and for helping to determine the appropriate timing and method of intervention. This guideline from the British Society of Echocardiography (BSE) describes the assessment of mitral regurgitation and mitral stenosis, and replaces previous BSE guidelines that describe the echocardiographic assessment of mitral anatomy prior to mitral valve repair surgery and percutaneous mitral valvuloplasty. It provides a comprehensive description of the imaging techniques (and their limitations) employed in the assessment of mitral valve disease. It describes a step-wise approach to identifying: aetiology and mechanism, disease severity, reparability and secondary effects on chamber geometry, function and pressures. Advanced echocardiographic techniques are described for both transthoracic and transoesophageal modalities, including TOE and exercise testing.

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Authors and Affiliations

  1. Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, Cambridgeshire, UK

    Shaun Robinson MSc

  2. West Suffolk Hospital NHS Foundation Trust, Bury St Edmunds, Suffolk, UK

    Liam Ring MBBS

  3. Royal United Hospitals Bath NHS Foundation Trust, Bath, UK

    Daniel X. Augustine MD

  4. Department for Health, University of Bath, Bath, UK

    Daniel X. Augustine MD

  5. Nottingham University Hospitals NHS Trust, Nottongham, UK

    Sushma Rekhraj MD

  6. Liverpool John Moores University, Research Institute for Sports and Exercise Science, Liverpool, Merseyside, UK

    David Oxborough PhD

  7. Department of Cardiology, Colchester Hospital NHS Trust, Colchester, UK

    Allan Harkness MSc

  8. University of Liège, Leige, Belgium

    Patrizio Lancellotti PhD

  9. Imperial College Healthcare NHS Trust, London, UK

    Bushra Rana MBBS

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  1. Shaun Robinson MSc
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  2. Liam Ring MBBS
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  3. Daniel X. Augustine MD
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  4. Sushma Rekhraj MD
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  8. Bushra Rana MBBS
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Correspondence to Shaun Robinson MSc.

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Robinson, S., Ring, L., Augustine, D.X. et al. The assessment of mitral valve disease: a guideline from the British Society of Echocardiography. Echo Res Pract 8, G87–G136 (2021). https://doi.org/10.1530/ERP-20-0034

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  • DOI: https://doi.org/10.1530/ERP-20-0034

Key Words

  • mitral regurgitation
  • mitral stenosis
  • transthoracic echocardiography
  • tranoesophageal echocardiography

Echo Research & Practice

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