Silvia Pradella1, Giulia Grazzini2, Marta Brandani2, Linda Calistri2, Cosimo Nardi2, Fabio Mori3, Vittorio Miele4, Stefano Colagrande2. 1. Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy. pradella3@yahoo.it. 2. Department of Experimental and Clinical Biomedical Sciences, University of Florence - Careggi University Hospital, Radiodiagnostic Unit n. 2, Largo Brambilla 3, 50134, Florence, Italy. 3. Department of Cardiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy. 4. Department of Radiology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
Abstract
OBJECTIVES: To evaluate the incidence of late-gadolinium-enhancement (LGE) in mitral valve prolapse (MVP) (in the absence of other heart/valvular diseases), and its association with the degree of mitral regurgitation (MR) and/or with complex ventricular arrhythmia (ComVA), and to analyse the role of T1 mapping in the evaluation of MVP patients. METHODS: We included all consecutive patients with MVP who underwent during 2015-2016 a comprehensive cardiac magnetic resonance (CMR) examination at 1.5 T. We evaluated the association of LGE with the MR fraction and the presence of ComVA. We compared myocardial T1-native and post-contrast times and extracellular volume (ECV)-values between MVP patients, both with and without LGE, and the control group. RESULTS: Thirty-four patients with MVP were selected (56 ± 14 years old, 59% male). All patients had MR; LGE and ComVA were present in 15 (44%) and 11 (34%) patients, respectively. Significant associations of LGE with both MR severity and ComVA were not found (p=0.72 and 0.79, respectively). T1 mapping confirmed the presence of LGE in all cases. In one patient a thin signal alteration resulted in more evident T1 mapping than LGE. Patients with MVP had higher native T1-values, lower post-contrast T1-values and increased ECV-values compared with controls (p=0.01, 0.01 and 0.00, respectively). CONCLUSION: Focal fibrosis with LGE was found in about half the MVP patients and it was independent of the degree of the valve dysfunction and the presence of ComVA. T1 mapping allows diffuse myocardial wall alterations to be identified, but no significant associations between the MR severity and ComVA and T1/ECV values were found. KEY POINTS: • MVP is a common valvulopathy affecting 2-3% of the general population. • MVP has been associated with an increased risk of arrhythmic complications and sudden cardiac death. • CMR is a non-invasive imaging method that provides a precise and more accurate assessment of patients with MVP.
OBJECTIVES: To evaluate the incidence of late-gadolinium-enhancement (LGE) in mitral valve prolapse (MVP) (in the absence of other heart/valvular diseases), and its association with the degree of mitral regurgitation (MR) and/or with complex ventricular arrhythmia (ComVA), and to analyse the role of T1 mapping in the evaluation of MVP patients. METHODS: We included all consecutive patients with MVP who underwent during 2015-2016 a comprehensive cardiac magnetic resonance (CMR) examination at 1.5 T. We evaluated the association of LGE with the MR fraction and the presence of ComVA. We compared myocardial T1-native and post-contrast times and extracellular volume (ECV)-values between MVP patients, both with and without LGE, and the control group. RESULTS: Thirty-four patients with MVP were selected (56 ± 14 years old, 59% male). All patients had MR; LGE and ComVA were present in 15 (44%) and 11 (34%) patients, respectively. Significant associations of LGE with both MR severity and ComVA were not found (p=0.72 and 0.79, respectively). T1 mapping confirmed the presence of LGE in all cases. In one patient a thin signal alteration resulted in more evident T1 mapping than LGE. Patients with MVP had higher native T1-values, lower post-contrast T1-values and increased ECV-values compared with controls (p=0.01, 0.01 and 0.00, respectively). CONCLUSION: Focal fibrosis with LGE was found in about half the MVP patients and it was independent of the degree of the valve dysfunction and the presence of ComVA. T1 mapping allows diffuse myocardial wall alterations to be identified, but no significant associations between the MR severity and ComVA and T1/ECV values were found. KEY POINTS: • MVP is a common valvulopathy affecting 2-3% of the general population. • MVP has been associated with an increased risk of arrhythmic complications and sudden cardiac death. • CMR is a non-invasive imaging method that provides a precise and more accurate assessment of patients with MVP.
Entities:
Keywords:
Cine magnetic resonance imaging; Gadolinium; Prolapsed mitral valve; T1 mapping
Authors: Manuel D Cerqueira; Neil J Weissman; Vasken Dilsizian; Alice K Jacobs; Sanjiv Kaul; Waren K Laskey; Dudley J Pennell; John A Rumberger; Thomas Ryan; Mario S Verani Journal: Int J Cardiovasc Imaging Date: 2002-02 Impact factor: 2.357
Authors: Martin Ugander; Abiola J Oki; Li-Yueh Hsu; Peter Kellman; Andreas Greiser; Anthony H Aletras; Christopher T Sibley; Marcus Y Chen; W Patricia Bandettini; Andrew E Arai Journal: Eur Heart J Date: 2012-01-24 Impact factor: 29.983
Authors: Eli V Gelfand; Sean Hughes; Thomas H Hauser; Susan B Yeon; Lois Goepfert; Kraig V Kissinger; Neil M Rofsky; Warren J Manning Journal: J Cardiovasc Magn Reson Date: 2006 Impact factor: 5.364
Authors: L A Freed; D Levy; R A Levine; M G Larson; J C Evans; D L Fuller; B Lehman; E J Benjamin Journal: N Engl J Med Date: 1999-07-01 Impact factor: 91.245
Authors: Nathan Mewton; Chia Ying Liu; Pierre Croisille; David Bluemke; João A C Lima Journal: J Am Coll Cardiol Date: 2011-02-22 Impact factor: 24.094
Authors: Yuchi Han; Dana C Peters; Carol J Salton; Dorota Bzymek; Reza Nezafat; Beth Goddu; Kraig V Kissinger; Peter J Zimetbaum; Warren J Manning; Susan B Yeon Journal: JACC Cardiovasc Imaging Date: 2008-05
Authors: Frank Weidemann; Sebastian Herrmann; Stefan Störk; Markus Niemann; Stefan Frantz; Volkmar Lange; Meinrad Beer; Stefan Gattenlöhner; Wolfram Voelker; Georg Ertl; Jörg M Strotmann Journal: Circulation Date: 2009-08-03 Impact factor: 29.690
Authors: Christopher A Miller; Josephine H Naish; Paul Bishop; Glyn Coutts; David Clark; Sha Zhao; Simon G Ray; Nizar Yonan; Simon G Williams; Andrew S Flett; James C Moon; Andreas Greiser; Geoffrey J M Parker; Matthias Schmitt Journal: Circ Cardiovasc Imaging Date: 2013-04-03 Impact factor: 7.792
Authors: Marco Gatti; Anna Palmisano; Antonio Esposito; Stefano Fiore; Caterina Beatrice Monti; Alessandro Andreis; Lorenzo Pistelli; Pasquale Vergara; Laura Bergamasco; Carla Giustetto; Francesco De Cobelli; Paolo Fonio; Riccardo Faletti Journal: Eur Radiol Date: 2021-04-19 Impact factor: 5.315
Authors: Ernesto Di Cesare; Scipione Carerj; Anna Palmisano; Maria Ludovica Carerj; Federica Catapano; Davide Vignale; Annamaria Di Cesare; Gianluca Milanese; Nicola Sverzellati; Marco Francone; Antonio Esposito Journal: Radiol Med Date: 2020-07-16 Impact factor: 3.469