Multimodality Imaging Assessment of the Severity of Mitral Regurgitation

Inclusion Criteria:

1. age ≥ 18 years old
2. all-caused moderate or severe MR assessed by Trans-Thoracic Echocardiography (TTE) :

1. EROA ≥0.3cm^2; 2) RVol ≥45ml

3. The patient has signed an informed consent form.

Exclusion Criteria:

1. unstable angina, acute myocardial infarction and surgical history of coronary arterybypass grafting (CABG) and percutaneous coronary intervention (PCI) within 3 monthsbefore recruit
2. acute heart failure or acute worsening of chronic heart failure requiring vasoactivedrug therapy
3. severe infections, septicaemia
4. severe hepatic insufficiency ( Child-Pugh class C)
5. severe renal insufficiency ( chronic kidney disease (CKD) stage 5: estimatedglomerular filtration rate (eGFR) <15ml/min or dialysis)
6. hypotensive state, shock ( systolic blood pressure <90mmHg or mean arterial pressure <70mmHg with tissue hypoperfusion and urine output <30ml/h)
7. uncontrolled diseases of the haematological system: acute gastrointestinal bleeding,intracranial haemorrhage or haemorrhage from other organs, acute pulmonary embolism ordeep vein thrombosis, congenital or acquired haemorrhagic disease such as haemophilia,anaphylactic purpura and acute leukaemia, severe abnormalities in haematologicalparameters such as platelet count <20*10^9/l and international normalized ratio (INR) >3
8. contraindication for Trans-Esophageal Echocardiography (TEE) such as oesophagealconstriction, oesophageal tumour, oesophageal fistula, oesophageal varices, cervicalvertebral instability
9. contraindication for CMR such as metal foreign matter in the body, claustrophobia
10. contraindication for intravenous anaesthesia such as allergy to anaesthetics
11. pregnancy or breastfeeding
12. The patient does not sign an informed consent form.
13. Due to other reasons the patient is not suitable for enrollment assessed by theresearcher.