ArticleThe international journal of cardiovascular imaging2024
Left ventricular fibrosis and CMR tissue characterization of papillary muscles in mitral valve prolapse patients.
Article in The international journal of cardiovascular imaging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 5 citations in OpenAlex.
- Myocardial late gadolinium enhancement is strongly associated with ventricular arrhythmias in mitral valve prolapse.The international journal of cardiovascular imaging · 2026Article
- The Arrhythmogenic Spectrum of Mitral Valve Disease: Pathophysiology, Risk Stratification, and Surgical Management.Journal of clinical medicine · 2026Review
- Multimodality cardiovascular imaging in arrhythmic mitral valve prolapse: a state-of-the-art review from structural assessment to myocardial tissue characterization.Frontiers 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
- Collagen Fiber Maturity and Architecture in MVP-Associated Fibrosis Quantified by Digital Pathology.Cells · 2025Article
- Histological Evaluation for Collagen Expression Prior to LVAD Implantation Is Useful to Estimate Weaning Success.Biomedicines · 2025Article
- Arrhythmic Mitral Valve Prolapse: Pathophysiology, Diagnostics, and Management Strategies.Seminars in thoracic and cardiovascular surgery · 2025Review
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17 authors at 4 institutions in 2 countries.
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Abstract
purposeMitral valve prolapse (MVP) is associated with left ventricle (LV) fibrosis, including the papillary muscles (PM), which is in turn linked to malignant arrhythmias. This study aims to evaluate comprehensive tissue characterization of the PM by cardiovascular magnetic resonance (CMR) imaging and its association with LV fibrosis observed by intraoperative biopsies.
methodsMVP patients with indication for surgery due to severe mitral regurgitation (n = 19) underwent a preoperative CMR with characterization of the PM: dark-appearance on cine, T1 mapping, conventional bright blood (BB) and dark blood (DB) late gadolinium enhancement (LGE). CMR T1 mapping was performed on 21 healthy volunteers as controls. LV inferobasal myocardial biopsies were obtained in MVP patients and compared to CMR findings.
resultsMVP patients (54 ± 10 years old, 14 male) had a dark-appearance of the PM with higher native T1 and extracellular volume (ECV) values compared with healthy volunteers (1096 ± 78ms vs. 994 ± 54ms and 33.9 ± 5.6% vs. 25.9 ± 3.1%, respectively, p < 0.001). Seventeen MVP patients (89.5%) had fibrosis by biopsy. BB-LGE + in LV and PM was identified in 5 (26.3%) patients, while DB-LGE + was observed in LV in 9 (47.4%) and in PM in 15 (78.9%) patients. DB-LGE + in PM was the only technique that showed no difference with detection of LV fibrosis by biopsy. Posteromedial PM was more frequently affected than the anterolateral (73.7% vs. 36.8%, p = 0.039) and correlated with biopsy-proven LV fibrosis (Rho 0.529, p = 0.029).
conclusionsCMR imaging in MVP patients referred for surgery shows a dark-appearance of the PM with higher T1 and ECV values compared with healthy volunteers. The presence of a positive DB-LGE at the posteromedial PM by CMR may serve as a better predictor of biopsy-proven LV inferobasal fibrosis than conventional CMR techniques.
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