The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse
Mitral valve prolapse (MVP), characterized by a displacement > 2 mm above the mitral annulus of one or both bileaflets, with or without leaflet thickening, is a common valvular heart disease, with a prevalence of approximately 2% in western countries. Although this population has a generally...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1093060/full |
| _version_ | 1811160809418522624 |
|---|---|
| author | Emmanuelle Vermes Alexandre Altes Alexandre Altes Laura Iacuzio Franck Levy Yohann Bohbot Yohann Bohbot Cédric Renard Francesco Grigioni Sylvestre Maréchaux Christophe Tribouilloy Christophe Tribouilloy |
| author_facet | Emmanuelle Vermes Alexandre Altes Alexandre Altes Laura Iacuzio Franck Levy Yohann Bohbot Yohann Bohbot Cédric Renard Francesco Grigioni Sylvestre Maréchaux Christophe Tribouilloy Christophe Tribouilloy |
| author_sort | Emmanuelle Vermes |
| collection | DOAJ |
| description | Mitral valve prolapse (MVP), characterized by a displacement > 2 mm above the mitral annulus of one or both bileaflets, with or without leaflet thickening, is a common valvular heart disease, with a prevalence of approximately 2% in western countries. Although this population has a generally good overall prognosis, MVP can be associated with mitral regurgitation (MR), left ventricular (LV) remodeling leading to heart failure, ventricular arrhythmia, and, the most devastating complication, sudden cardiac death, especially in myxomatous bileaflet prolapse (Barlow's disease). Among several prognostic factors reported in the literature, LV fibrosis and mitral annular disjunction may act as an arrhythmogenic substrate in this population. Cardiac magnetic resonance (CMR) has emerged as a reliable tool for assessing MVP, MR severity, LV remodeling, and fibrosis. Indeed, CMR is the gold standard imaging modality to assess ventricular volume, function, and wall motion abnormalities; it allows accurate calculation of the regurgitant volume and regurgitant fraction in MR using a combination of LV volumetric measurement and aortic flow quantification, independent of regurgitant jet morphology and valid in cases of multiple valvulopathies. Moreover, CMR is a unique imaging modality that can assess non-invasively focal and diffuse fibrosis using late gadolinium enhancement sequences and, more recently, T1 mapping. This review describes the use of CMR in patients with MVP and its role in identifying patients at high risk of ventricular arrhythmia. |
| first_indexed | 2024-04-10T06:03:51Z |
| format | Article |
| id | doaj.art-5e7425fd6186428aa70df057e3857856 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T06:03:51Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5e7425fd6186428aa70df057e38578562023-03-03T04:28:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-03-011010.3389/fcvm.2023.10930601093060The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapseEmmanuelle Vermes0Alexandre Altes1Alexandre Altes2Laura Iacuzio3Franck Levy4Yohann Bohbot5Yohann Bohbot6Cédric Renard7Francesco Grigioni8Sylvestre Maréchaux9Christophe Tribouilloy10Christophe Tribouilloy11Department of Cardiology, Amiens University Hospital, Amiens, FranceDepartment of Cardiology, Heart Valve Center, Lille Catholic Hospitals, GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille, Lille Catholic University, Lille, FranceDivision of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, BelgiumDepartment of Cardiology, Centre Cardio-Thoracique de Monaco, Monaco, MonacoDepartment of Cardiology, Centre Cardio-Thoracique de Monaco, Monaco, MonacoDepartment of Cardiology, Amiens University Hospital, Amiens, FranceUR UPJV 7517, Jules Verne University of Picardie, Amiens, FranceDepartment of Radiology, Amiens University Hospital, Amiens, FranceDivision of Cardiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma and Fondazione Policlinico Universitario Campus Bio-Medico, Rome, ItalyDepartment of Cardiology, Heart Valve Center, Lille Catholic Hospitals, GCS-Groupement des Hôpitaux de l'Institut Catholique de Lille, Lille Catholic University, Lille, FranceDepartment of Cardiology, Amiens University Hospital, Amiens, FranceUR UPJV 7517, Jules Verne University of Picardie, Amiens, FranceMitral valve prolapse (MVP), characterized by a displacement > 2 mm above the mitral annulus of one or both bileaflets, with or without leaflet thickening, is a common valvular heart disease, with a prevalence of approximately 2% in western countries. Although this population has a generally good overall prognosis, MVP can be associated with mitral regurgitation (MR), left ventricular (LV) remodeling leading to heart failure, ventricular arrhythmia, and, the most devastating complication, sudden cardiac death, especially in myxomatous bileaflet prolapse (Barlow's disease). Among several prognostic factors reported in the literature, LV fibrosis and mitral annular disjunction may act as an arrhythmogenic substrate in this population. Cardiac magnetic resonance (CMR) has emerged as a reliable tool for assessing MVP, MR severity, LV remodeling, and fibrosis. Indeed, CMR is the gold standard imaging modality to assess ventricular volume, function, and wall motion abnormalities; it allows accurate calculation of the regurgitant volume and regurgitant fraction in MR using a combination of LV volumetric measurement and aortic flow quantification, independent of regurgitant jet morphology and valid in cases of multiple valvulopathies. Moreover, CMR is a unique imaging modality that can assess non-invasively focal and diffuse fibrosis using late gadolinium enhancement sequences and, more recently, T1 mapping. This review describes the use of CMR in patients with MVP and its role in identifying patients at high risk of ventricular arrhythmia.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1093060/fullmitral valve prolapsemitral annular disjunctioncardiovascular magnetic resonancemyocardial fibrosisextracellular volume |
| spellingShingle | Emmanuelle Vermes Alexandre Altes Alexandre Altes Laura Iacuzio Franck Levy Yohann Bohbot Yohann Bohbot Cédric Renard Francesco Grigioni Sylvestre Maréchaux Christophe Tribouilloy Christophe Tribouilloy The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse Frontiers in Cardiovascular Medicine mitral valve prolapse mitral annular disjunction cardiovascular magnetic resonance myocardial fibrosis extracellular volume |
| title | The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse |
| title_full | The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse |
| title_fullStr | The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse |
| title_full_unstemmed | The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse |
| title_short | The evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse |
| title_sort | evolving role of cardiovascular magnetic resonance in the assessment of mitral valve prolapse |
| topic | mitral valve prolapse mitral annular disjunction cardiovascular magnetic resonance myocardial fibrosis extracellular volume |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1093060/full |
| work_keys_str_mv | AT emmanuellevermes theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT alexandrealtes theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT alexandrealtes theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT lauraiacuzio theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT francklevy theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT yohannbohbot theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT yohannbohbot theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT cedricrenard theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT francescogrigioni theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT sylvestremarechaux theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT christophetribouilloy theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT christophetribouilloy theevolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT emmanuellevermes evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT alexandrealtes evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT alexandrealtes evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT lauraiacuzio evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT francklevy evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT yohannbohbot evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT yohannbohbot evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT cedricrenard evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT francescogrigioni evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT sylvestremarechaux evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT christophetribouilloy evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse AT christophetribouilloy evolvingroleofcardiovascularmagneticresonanceintheassessmentofmitralvalveprolapse |