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Mitral Annulus Disjunction: A Comprehensive Cardiovascular Magnetic Resonance Phenotype and Clinical Outcomes Study
Pedro Custódio1,2, Diana de Campos1,3, Ana Rita Moura1,4
1St Bartholomew's Hospital, London, UK.
Journal of Magnetic Resonance Imaging : JMRI
|July 10, 2024
Summary
Mitral annulus disjunction (MAD) severity is linked to mitral valve dysfunction. While scar tissue is associated with non-sustained ventricular arrhythmias, the risk of sustained arrhythmias and cardiovascular death in MAD patients is low.
Area of Science:
- Cardiology
- Cardiac Imaging
- Electrophysiology
Background:
- The clinical significance of mitral annulus disjunction (MAD) remains unclear.
- Characterizing MAD patients diagnosed via cardiac magnetic resonance imaging (MRI) is crucial.
Purpose of the Study:
- To define the characteristics of a diverse group of patients with mitral annulus disjunction (MAD) identified through cardiac MRI.
- To investigate the relationship between MAD, cardiac scarring (late gadolinium enhancement), and arrhythmias.
Main Methods:
- Retrospective analysis of 222 patients diagnosed with MAD by cardiac MRI.
- Assessment of MAD extent, mitral annulus systolic expansion, and late gadolinium enhancement (LGE) patterns.
- Correlation of imaging findings with clinical history, ventricular arrhythmias (VA), and cardiovascular outcomes.
Main Results:
- MAD extent averaged 5.0 mm; significant systolic expansion occurred with MAD ≥6 mm, associated with mitral valve prolapse.
- Late gadolinium enhancement (LGE) was present in 36.9% of patients, with 10.4% showing MAD-related LGE.
- Non-sustained VA (NSVA) was more prevalent with MAD ≥6 mm and associated with global LGE, not specifically MAD-related LGE.
Conclusions:
- Mitral valve dysfunction correlates with MAD severity in patients undergoing cardiac MRI.
- Cardiac scar extent is not directly related to MAD extent but is associated with NSVA.
- This study indicates a low risk of sustained arrhythmias and cardiovascular death in the studied MAD population.
Keywords:
cardiac magnetic resonancemitral annulus disjunctionmitral prolapsesudden cardiac deathsystolic expansionventricular arrhythmiaMore Related Videos
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