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Late gadolinium enhancement CMR in primary mitral regurgitation

Caroline M Van De Heyning1, Julien Magne, Luc A Piérard

  • 1GIGA Cardiovascular Sciences, Heart Valve Clinic, Department of Cardiology, CHU Sart Tilman, University of Liège Hospital, Liège, Belgium; Department of Cardiology, University of Antwerp Hospital, Edegem, Belgium.

European Journal of Clinical Investigation
|July 29, 2014
PubMed
Abstract

Insights

Late gadolinium enhancement on cardiovascular magnetic resonance (LGE CMR) may indicate myocardial fibrosis in patients with asymptomatic primary mitral regurgitation (MR). This finding is associated with left ventricular remodeling, suggesting potential implications for risk stratification.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac MRI

Background:

  • The optimal timing for surgical intervention in severe asymptomatic primary mitral regurgitation (MR) remains a clinical challenge.
  • Late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) can identify myocardial fibrosis and is linked to adverse outcomes in various heart conditions.

Purpose of the Study:

  • To determine the prevalence and clinical significance of LGE in patients with asymptomatic primary MR.
  • To explore the association between LGE and left ventricular (LV) remodeling in this patient cohort.

Main Methods:

  • Prospective study including 41 patients with moderate to severe primary MR without overt LV dysfunction.
  • Exclusion of patients with coronary artery disease, arrhythmias, or significant concomitant valvular disease.
  • All participants underwent transthoracic echocardiography and LGE CMR.

Main Results:

  • Interpretable LGE CMR images were obtained in 39 patients; 12 (31%) showed delayed contrast uptake in the LV wall.
  • LGE patterns included infarct (n=3), mid-wall fibrosis (n=7), and combined patterns (n=2).
  • Patients with LGE exhibited significantly larger LV end-systolic (39±4 vs. 34±5 mm) and end-diastolic diameters (57±5 vs. 50±5 mm) compared to those without LGE.

Conclusions:

  • The presence of delayed enhancement on CMR in primary MR is associated with left ventricular remodeling.
  • Further research is required to ascertain if LGE CMR can predict unfavorable outcomes or enhance risk stratification in asymptomatic primary MR.
Keywords:
Cardiac magnetic resonanceechocardiographyfibrosismitral regurgitationvalve

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