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Updated: Jan 22, 2026

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
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Left atrioventricular coupling in isolated pediatric mitral valve prolapse with preserved ejection fraction and

Farah Ahmed Shokeir1, Aya Mohammed Abdel Aziz1, Rasha Karam1

  • 1Department of Radiology, Faculty of Medicine, Mansoura University, P.O. Box: 35516, El Gomhoria Street, Dakhlia governorate, Mansoura, Egypt.

Scientific Reports
|January 20, 2026
PubMed

Insights

This study reveals that strain parameters effectively assess left atrial and left ventricular coupling in pediatric mitral valve prolapse. Elevated native T1 values correlate with impaired cardiac function and coupling indices.

Area of Science:

  • Cardiology
  • Biomedical Imaging
  • Pediatric Heart Disease

Background:

  • Mitral valve prolapse (MVP) in pediatric patients can affect cardiac function.
  • Assessing the coupling between the left atrium (LA) and left ventricle (LV) is crucial for understanding cardiac mechanics in MVP.
  • Strain parameters and novel indices like the left atrioventricular coupling index (LACI) offer advanced insights.

Purpose of the Study:

  • To investigate the coupling between the left ventricle and left atrium in pediatric patients with MVP.
  • To evaluate the utility of strain parameters and LACI in assessing this coupling.
  • To explore correlations between LACI, strain parameters, and myocardial fibrosis using native T1 mapping.

Main Methods:

  • Retrospective analysis of 20 pediatric patients with MVP and moderate mitral regurgitation, compared to 20 healthy controls.
  • Cardiac MRI (CMR) for functional and strain assessments of LV, RV, and LA.
  • Calculation of LACI (LA end-diastolic volume indexed / LV end-diastolic volume indexed).
  • Native T1 mapping to assess diffuse myocardial fibrosis.

Main Results:

  • LACI negatively correlated with LV end-diastolic volume indexed to body surface area and total LA ejection fraction.
  • LACI correlated with LA longitudinal peak positive strain rate and LV global circumferential strain.
  • Left atrial longitudinal reservoir strain was independently associated with LV ejection fraction and LV global radial strain.
  • Differences in LACI and LA strain were observed between patients with and without clinical events (e.g., arrhythmia).
  • Elevated native T1 values correlated with LACI and impaired LV/LA strain parameters.

Conclusions:

  • Strain parameters are valuable tools for evaluating LA-LV coupling in pediatric MVP.
  • LACI and specific strain parameters provide significant insights into cardiac mechanics in this population.
  • Native T1 mapping may indicate myocardial fibrosis associated with impaired cardiac coupling in pediatric MVP.

Keywords:
Atrioventricular couplingCardiac MRIFeature trackingLeft atrioventricular coupling index (LACI)

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