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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
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Cardiac magnetic resonance assessment of mitral annular disjunction in children: insights from T1 mapping and

Selin Ardali Duzgun1, Ilker Ertugrul2, Hanife Avci3

  • 1Department of Radiology, Hacettepe University Faculty of Medicine, 06100, Sihhiye, Ankara, Turkey. selin.ardali@gmail.com.

Pediatric Radiology
|November 10, 2025
PubMed

Insights

Pediatric mitral annular disjunction shows early heart muscle changes like reduced strain and higher native T1/extracellular volume. Cardiac magnetic resonance (CMR) detects these subtle signs of remodeling in children.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Imaging

Background:

  • Mitral annular disjunction (MAD) is a structural heart abnormality linked to myocardial remodeling.
  • While adult MAD is studied, pediatric data is limited.

Purpose of the Study:

  • To evaluate early myocardial structural and functional changes in pediatric MAD.
  • Utilize cardiac magnetic resonance (CMR) feature-tracking strain and parametric mapping.

Main Methods:

  • Retrospective study of 32 pediatric MAD patients and 16 controls using CMR.
  • Assessed cine imaging, late gadolinium enhancement, T1 mapping, extracellular volume, and strain analysis.
  • Evaluated Holter data for ventricular ectopy.

Main Results:

  • MAD patients had reduced global, basal, and segmental strain values.
  • Elevated native T1 and extracellular volume observed in the MAD group.
  • Late gadolinium enhancement (21.9%) and ventricular ectopy (48.3%) were noted.

Conclusions:

  • Pediatric MAD is associated with early myocardial alterations, including impaired deformation and elevated native T1/extracellular volume.
  • Subclinical myocardial remodeling may start in childhood.
  • CMR is effective in detecting these subtle changes in pediatric MAD.
Abstract

Keywords:
Cardiac imaging techniquesChildrenMagnetic resonance imagingMitral valve

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