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Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice
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Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

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Evaluation of myocardial function and structure in valvular heart disease: what is needed for risk assessment and

Erwan Donal1, Marina Petersen Saadi1, Marc Dweck2

  • 1University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, 2 rue Henri le Guilloux, 35033, Rennes F-35000, France.

European Heart Journal. Cardiovascular Imaging
|January 12, 2026
PubMed

Insights

Valvular heart disease (VHD) is a myocardial disease. New imaging tools detect heart muscle injury early, enabling better management focused on the ventricle, not just the valve.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Biomedical Engineering

Background:

  • Traditional valvular heart disease (VHD) assessment focuses on valve function, often missing early myocardial injury.
  • Emerging evidence classifies VHD as a myocardial disease, where ventricular response significantly impacts outcomes.
  • Current methods may fail to detect dysfunction until advanced stages.

Purpose of the Study:

  • To redefine VHD assessment through a myocardium-first approach.
  • To highlight advanced imaging tools for early detection of myocardial dysfunction in VHD.
  • To propose a new management strategy centered on myocardial protection.

Main Methods:

  • Review of contemporary evidence and state-of-the-art imaging techniques.
  • Focus on specific myocardial strain parameters: LV global longitudinal strain (LV-GLS), RV strain with RV-PA coupling, and LA reservoir strain.
  • Integration of cardiac magnetic resonance (CMR) parameters (native T1, ECV, LGE) and next-generation technologies (CT-ECV, molecular imaging, AI).

Main Results:

  • A triad of strain measures (LV-GLS, RV-PA coupling, LA strain) detects myocardial injury early and improves prognostic accuracy.
  • CMR identifies diffuse and focal fibrosis, crucial for understanding remodeling.
  • Advanced technologies like CT-ECV, molecular imaging, and AI offer scalable and personalized risk assessment.

Conclusions:

  • VHD management should prioritize myocardial health, shifting focus from valve correction to ventricle protection.
  • A serial, multiparametric, AI-enhanced strategy utilizing advanced imaging can guide interventions during the optimal therapeutic window.
  • This myocardium-centric approach is essential for preserving cardiac function in VHD patients.

Keywords:
multimodality imaging (echo, CMR, CT, PET)myocardial functionvalvular heart disease

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