PMID- 19356441
OWN - NLM
STAT- MEDLINE
DCOM- 20090423
LR  - 20220310
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 1
IP  - 3
DP  - 2008 May
TI  - Cardiovascular magnetic resonance characterization of mitral valve prolapse.
PG  - 294-303
LID - 10.1016/j.jcmg.2008.01.013 [doi]
AB  - OBJECTIVES: This study sought to develop cardiovascular magnetic resonance (CMR) 
      diagnostic criteria for mitral valve prolapse (MVP) using echocardiography as the 
      gold standard and to characterize MVP using cine CMR and late gadolinium 
      enhancement (LGE)-CMR. BACKGROUND: Mitral valve prolapse is a common valvular 
      heart disease with significant complications. Cardiovascular magnetic resonance 
      is a valuable imaging tool for assessing ventricular function, quantifying 
      regurgitant lesions, and identifying fibrosis, but its potential role in 
      evaluating MVP has not been defined. METHODS: To develop CMR diagnostic criteria 
      for MVP, characterize mitral valve morphology, we analyzed transthoracic 
      echocardiography and cine CMR images from 25 MVP patients and 25 control 
      subjects. Leaflet thickness, length, mitral annular diameters, and prolapsed 
      distance were measured. Two- and three-dimensional LGE-CMR images were obtained 
      in 16 MVP and 10 control patients to identify myocardial regions of fibrosis in 
      MVP. RESULTS: We found that a 2-mm threshold for leaflet excursion into the left 
      atrium in the left ventricular outflow tract long-axis view yielded 100% 
      sensitivity and 100% specificity for CMR using transthoracic echocardiography as 
      the clinical gold standard. Compared with control subjects, CMR identified MVP 
      patients as having thicker (3.2 +/- 0.1 mm vs. 2.3 +/- 0.1 mm) and longer (10.5 
      +/- 0.5 mm/m(2) vs. 7.1 +/- 0.3 mm/m(2)) indexed posterior leaflets and larger 
      indexed mitral annular diameters (27.8 +/- 0.7 mm/m(2) vs. 21.5 +/- 0.5 mm/m(2) 
      for long axis and 22.9 +/-0.7 mm/m(2) vs. 17.8 +/- 0.6 mm/m(2) for short axis). 
      In addition, we identified focal regions of LGE in the papillary muscles 
      suggestive of fibrosis in 10 (63%) of 16 MVP patients and in 0 of 10 control 
      subjects. Papillary muscle LGE was associated with the presence of complex 
      ventricular arrhythmias in MVP patients. CONCLUSIONS: Cardiovascular magnetic 
      resonance image can identify MVP by the same echocardiographic criteria and can 
      identify myocardial fibrosis involving the papillary muscle in MVP patients. 
      Hyperenhancement of papillary muscles on LGE is often present in a subgroup of 
      patients with complex ventricular arrhythmias.
FAU - Han, Yuchi
AU  - Han Y
AD  - Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical 
      Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA. 
      yhan@bidmc.harvard.edu
FAU - Peters, Dana C
AU  - Peters DC
FAU - Salton, Carol J
AU  - Salton CJ
FAU - Bzymek, Dorota
AU  - Bzymek D
FAU - Nezafat, Reza
AU  - Nezafat R
FAU - Goddu, Beth
AU  - Goddu B
FAU - Kissinger, Kraig V
AU  - Kissinger KV
FAU - Zimetbaum, Peter J
AU  - Zimetbaum PJ
FAU - Manning, Warren J
AU  - Manning WJ
FAU - Yeon, Susan B
AU  - Yeon SB
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2008 May;1(3):304-6. PMID: 19225572
MH  - Arrhythmias, Cardiac/etiology/pathology
MH  - Case-Control Studies
MH  - Contrast Media
MH  - Echocardiography, Doppler
MH  - Fibrosis
MH  - Gadolinium DTPA
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - *Magnetic Resonance Imaging, Cine
MH  - Mitral Valve/diagnostic imaging/*pathology
MH  - Mitral Valve Prolapse/complications/diagnostic imaging/*pathology
MH  - Papillary Muscles/*pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Sensitivity and Specificity
EDAT- 2009/04/10 09:00
MHDA- 2009/04/25 09:00
CRDT- 2009/04/10 09:00
PHST- 2007/11/02 00:00 [received]
PHST- 2008/01/04 00:00 [revised]
PHST- 2008/01/15 00:00 [accepted]
PHST- 2009/04/10 09:00 [entrez]
PHST- 2009/04/10 09:00 [pubmed]
PHST- 2009/04/25 09:00 [medline]
AID - S1936-878X(08)00029-6 [pii]
AID - 10.1016/j.jcmg.2008.01.013 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2008 May;1(3):294-303. doi: 10.1016/j.jcmg.2008.01.013.