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Advanced Imaging of Mitral Annular Disjunction: Where Are We?

Silvia Pradella1, Giulia Grazzini1, Rocco Pio Basile1

  • 1Department of Emergency Radiology, Careggi University Hospital, Florence, Italy.

Echocardiography (Mount Kisco, N.Y.)
|September 2, 2025
PubMed

Insights

Mitral annular disjunction (MAD) is a heart condition where the mitral valve annulus separates from the ventricle. Advanced imaging like CMR is crucial for diagnosing MAD and understanding its link to arrhythmias.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Electrophysiology

Background:

  • Mitral annular disjunction (MAD) is a structural abnormality involving separation of the mitral valve annulus from the left ventricular myocardium.
  • Initially overlooked, MAD is gaining attention for its potential association with mitral valve dysfunction and arrhythmias, including non-sustained ventricular tachycardia.
  • The independent role of MAD in causing arrhythmias is still under investigation.

Purpose of the Study:

  • To provide a comprehensive review of current literature on Mitral Annular Disjunction (MAD).
  • To focus on the diagnosis and clinical significance of MAD.
  • To highlight the application of advanced imaging modalities in MAD assessment.

Main Methods:

  • Literature review of studies on Mitral Annular Disjunction (MAD).
  • Emphasis on diagnostic capabilities of advanced imaging techniques.
  • Inclusion of data on cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT).

Main Results:

  • Advanced imaging, particularly CMR, is effective in diagnosing MAD.
  • CMR can detect myocardial fibrosis, aiding in the evaluation of MAD's implications.
  • MAD's association with arrhythmogenic events is suggested but requires further research.

Conclusions:

  • MAD diagnosis and clinical significance are increasingly recognized.
  • Advanced imaging techniques like CMR and CCT are vital for MAD assessment.
  • Further research is needed to clarify MAD's independent role in arrhythmogenesis.
Keywords:
arrhythmiascardiac computed tomography (CCT)cardiac magnetic resonance imaging (CMR)mitral annular disjunction (MAD)mitral valve prolapse (MVP)

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