Observational studyJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2020
Myocardial fibrosis in asymptomatic and symptomatic chronic severe primary mitral regurgitation and relationship to tissue characterisation and left ventricular function on cardiovascular magnetic resonance.
Observational study in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02355418 (A Prospective Observational Study Examining the Role of Myocardial Fibrosis in Outcome Following Mitral Valve Repair in Degenerative Mitral Regurgitation.), which is not on this map. Cited by 19 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Observational Study Examining the Role of Myocardial Fibrosis in Outcome Following Mitral Valve Repair in Degenerative Mitral Regurgitation.
Who cites it
19 citing papers in PubMed, 24 citations in OpenAlex.
- Mitral Regurgitation in Contemporary Practice: From Diagnosis to Management.Reviews in cardiovascular medicine · 2026Review
- A unified finite element framework for cardiac growth and remodeling in mitral regurgitation incorporating fiber reorientation and baroreflex.Acta biomaterialia · 2026Article
- The correlation between serum ECM1 and cardiac fibrosis in heart failure patients.BMC cardiovascular disorders · 2025Article
- Does Preliminary Chest Shape Assessment Improve the Prognostic Risk Stratification of Symptomatic Individuals with Primary Mitral Regurgitation? A Narrative Review of Traditional and Innovative Prognostic Indicators.Journal of clinical medicine · 2025Review
- Persistent Shift in Principal Strain Angles and Postsurgical Decline in Left Ventricular Ejection Fraction in Patients With Primary Mitral Regurgitation.Journal of the American Heart Association · 2025Article
- The prognostic importance of left ventricular diastolic function in primary mitral regurgitation and its relation to structural changes by CMR.Scientific reports · 2025Article
- Relationship between left ventricular wall stress and cardiac remodelling post-TAVR and MitraClip.Open heart · 2025Article
- Cardiovascular magnetic resonance imaging in mitral valve disease.European heart journal · 2025Review
- The Role of Global Longitudinal Strain in the Follow-Up of Asymptomatic Patients with Chronic Primary Mitral Regurgitation.Journal of clinical medicine · 2024Article
- Are Endomyocardial Ventricular Biopsies Useful for Assessing Myocardial Fibrosis?Journal of clinical medicine · 2024Article
- Primary mitral regurgitation: Toward a better quantification on left ventricular consequences.Clinical cardiology · 2024Article
- Left ventricular fibrosis and CMR tissue characterization of papillary muscles in mitral valve prolapse patients.The international journal of cardiovascular imaging · 2024Article
- Imminent risk of LVEF decline in asymptomatic patients with primary mitral regurgitation.Frontiers in cardiovascular medicine · 2024Article
- Association of myocardial iron deficiency based on T2* CMR with the risk of mild left ventricular dysfunction in HIV-1-infected patients.Frontiers in cardiovascular medicine · 2023Article
- Histopathological insights into mitral valve prolapse-induced fibrosis.Frontiers in cardiovascular medicine · 2023Review
- 2021 - State of our JCMR.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022Review
- Valvular Cardiomyopathy: The Value of Cardiovascular Magnetic Resonance Imaging.Cardiology research and practice · 2022Review
- Late plasma exosome microRNA-21-5p depicts magnitude of reverse ventricular remodeling after early surgical repair of primary mitral valve regurgitation.Frontiers in cardiovascular medicine · 2022Article
- Osteopathic Palpation of the Heart.Cureus · 2021Review
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundMyocardial fibrosis occurs in end-stage heart failure secondary to mitral regurgitation (MR), but it is not known whether this is present before onset of symptoms or myocardial dysfunction. This study aimed to characterise myocardial fibrosis in chronic severe primary MR on histology, compare this to tissue characterisation on cardiovascular magnetic resonance (CMR) imaging, and investigate associations with symptoms, left ventricular (LV) function, and exercise capacity.
methodsPatients with class I or IIa indications for surgery underwent CMR and cardiopulmonary exercise testing. LV biopsies were taken at surgery and the extent of fibrosis was quantified on histology using collagen volume fraction (CVF
results120 consecutive patients (64 ± 13 years; 71% male) were recruited; 105 patients underwent MV repair while 15 chose conservative management. LV biopsies were obtained in 86 patients (234 biopsy samples in total). MR patients had more fibrosis compared to 8 autopsy controls (median: 14.6% [interquartile range 7.4-20.3] vs. 3.3% [2.6-6.1], P < 0.001); this difference persisted in the asymptomatic patients (CVF
conclusionsPatients with chronic primary MR have increased fibrosis before the onset of symptoms. Due to the patchy nature of fibrosis, CMR derived ECV may be a better marker of global myocardial status. Clinical trial registration Mitral FINDER study; Clinical Trials NCT02355418, Registered 4 February 2015, https://clinicaltrials.gov/ct2/show/NCT02355418.
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