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High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
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Papillary Muscle Infarction by Cardiac MRI in Patients With Mitral Regurgitation

Jie Hou1,2,3, Yu Sun1,2,3, Huishan Wang4

  • 1College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, China.

Clinical Cardiology
|July 2, 2024
PubMed
Abstract

Insights

Papillary muscle infarction (PMI) detected by cardiac magnetic resonance imaging (CMR) is linked to poor outcomes in mitral regurgitation (MR) patients. PMI and longitudinal strain (LS) parameters offer valuable risk stratification for arrhythmia in MR.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiac Electrophysiology

Background:

  • Papillary muscle infarction (PMI) detected by cardiac magnetic resonance imaging (CMR) is associated with adverse outcomes in patients with mitral regurgitation (MR).
  • The prognostic value of specific papillary muscle (PM) parameters for MR management remains unclear.
  • This study aimed to evaluate the prognostic significance of PMI using CMR in patients with MR.

Purpose of the Study:

  • To investigate the prognostic value of papillary muscle infarction (PMI) detected by cardiac magnetic resonance imaging (CMR) in patients with mitral regurgitation (MR).
  • To assess the association of PMI and associated papillary muscle (PM) functional parameters with adverse outcomes, particularly arrhythmia, in MR patients.

Main Methods:

  • Retrospective enrollment of 397 patients with MR undergoing CMR between March 2018 and July 2023.
  • Qualitative and quantitative detection of PMI using CMR, alongside collection of clinical, echocardiography, and follow-up data.
  • Statistical analyses including logistic and Cox regression to identify independent predictors of PMI and arrhythmia.

Main Results:

  • Of 397 MR patients, 117 (29.5%) had PMI, predominantly in the posteromedial PM.
  • Patients with PMI exhibited decreased PM diastolic length and longitudinal strain (LS), and increased inter-PM distance compared to non-PMI patients (all p < 0.001).
  • PMI, reduced anterolateral PM-LS, and reduced posteromedial PM-LS were independently associated with increased arrhythmia risk during follow-up (p < 0.05).

Conclusions:

  • Cardiac magnetic resonance imaging (CMR)-derived papillary muscle infarction (PMI) and longitudinal strain (LS) parameters enhance the evaluation of PM dysfunction.
  • These parameters indicate a high risk for arrhythmia in patients with mitral regurgitation (MR).
  • PMI and associated functional parameters provide additive risk stratification for patients with MR.
Keywords:
arrhythmiamitral regurgitationpapillary musclepapillary muscle infarction

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