Cardiovascular magnetic resonance in patients with mitral valve prolapse

Stefano Figliozzi; Silvana Di Maio; Georgios Georgiopoulos; Bert Vandenberk; Amedeo Chiribiri; Marco Francone; Nay Aung; Steffen E. Petersen; Tim Leiner; Jan Bogaert; Pier-Giorgio Masci

doi:10.1016/j.jocmr.2024.101137

Cardiovascular magnetic resonance in patients with mitral valve prolapse

Stefano Figliozzi, Silvana Di Maio, Georgios Georgiopoulos, Bert Vandenberk, Amedeo Chiribiri, Marco Francone, Nay Aung, Steffen E. Petersen, Tim Leiner, Jan Bogaert, Pier-Giorgio Masci^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

28 Downloads (Pure)

Abstract

With a prevalence of 2–3% in the general population, mitral valve prolapse (MVP) is the most common valvular heart disease. The clinical course is benign in the majority of patients, although severe mitral regurgitation, heart failure, and sudden cardiac death affect a non-negligible subset of patients. Imaging of MVP was confined to echocardiography until a few years ago when it became apparent that cardiovascular magnetic resonance (CMR) could offer comparative advantages for detecting and quantifying mitral valve abnormalities alongside tissue myocardial characterization. The present review highlights the growing body of evidence supporting the role of CMR in patients with MVP. Based on the recent literature, CMR appears not as a simple alternative to echocardiography in patients with poor acoustic windows, but as a complementary imaging modality instrumental for better quantifying mitral valve abnormalities, mitral regurgitation severity, ventricular remodeling, and myocardial tissue changes. In this respect, pivotal CMR studies highlight that mitral annular disjunction and myocardial fibrosis by late gadolinium enhancement are associated with a heightened risk of life-threatening ventricular arrhythmias (arrhythmic MVP). We also delineate how these and other markers (e.g., the severity of mitral regurgitation) could enable a personalized risk assessment in patients with MVP and implement clinical decision-making. Here, we provide a comprehensive review of the current literature, with an emphasis on the arrhythmic MVP phenotype. The review also provides some practical suggestions on how to carry out a dedicated CMR protocol in MVP and composes a thorough report to inform clinicians on key aspects of this valvular heart disease.

Original language	English
Article number	101137
Journal	Journal of Cardiovascular Magnetic Resonance
Volume	27
Issue number	1
Early online date	15 Jan 2025
DOIs	https://doi.org/10.1016/j.jocmr.2024.101137
Publication status	E-pub ahead of print - 15 Jan 2025

Keywords

Mitral regurgitation
Mitral valve prolapse
Sudden cardiac death

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jocmr.2024.101137

Cardiovascular magnetic resonance_FIGLIOZZI_Publishedonline15January 2025_GOLD_VoR (CC BY)Final published version, 5.95 MBLicence: CC BY

Cite this

Figliozzi, S., Di Maio, S., Georgiopoulos, G., Vandenberk, B., Chiribiri, A., Francone, M., Aung, N., Petersen, S. E., Leiner, T., Bogaert, J., & Masci, P.-G. (2025). Cardiovascular magnetic resonance in patients with mitral valve prolapse. Journal of Cardiovascular Magnetic Resonance, 27(1), Article 101137. Advance online publication. https://doi.org/10.1016/j.jocmr.2024.101137

@article{2a85af2f19474334ad51571260e2dedd,

title = "Cardiovascular magnetic resonance in patients with mitral valve prolapse",

abstract = "With a prevalence of 2–3% in the general population, mitral valve prolapse (MVP) is the most common valvular heart disease. The clinical course is benign in the majority of patients, although severe mitral regurgitation, heart failure, and sudden cardiac death affect a non-negligible subset of patients. Imaging of MVP was confined to echocardiography until a few years ago when it became apparent that cardiovascular magnetic resonance (CMR) could offer comparative advantages for detecting and quantifying mitral valve abnormalities alongside tissue myocardial characterization. The present review highlights the growing body of evidence supporting the role of CMR in patients with MVP. Based on the recent literature, CMR appears not as a simple alternative to echocardiography in patients with poor acoustic windows, but as a complementary imaging modality instrumental for better quantifying mitral valve abnormalities, mitral regurgitation severity, ventricular remodeling, and myocardial tissue changes. In this respect, pivotal CMR studies highlight that mitral annular disjunction and myocardial fibrosis by late gadolinium enhancement are associated with a heightened risk of life-threatening ventricular arrhythmias (arrhythmic MVP). We also delineate how these and other markers (e.g., the severity of mitral regurgitation) could enable a personalized risk assessment in patients with MVP and implement clinical decision-making. Here, we provide a comprehensive review of the current literature, with an emphasis on the arrhythmic MVP phenotype. The review also provides some practical suggestions on how to carry out a dedicated CMR protocol in MVP and composes a thorough report to inform clinicians on key aspects of this valvular heart disease.",

keywords = "Mitral regurgitation, Mitral valve prolapse, Sudden cardiac death",

author = "Stefano Figliozzi and {Di Maio}, Silvana and Georgios Georgiopoulos and Bert Vandenberk and Amedeo Chiribiri and Marco Francone and Nay Aung and Petersen, {Steffen E.} and Tim Leiner and Jan Bogaert and Pier-Giorgio Masci",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2025",

month = jan,

day = "15",

doi = "10.1016/j.jocmr.2024.101137",

language = "English",

volume = "27",

journal = "Journal of Cardiovascular Magnetic Resonance",

issn = "1097-6647",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Cardiovascular magnetic resonance in patients with mitral valve prolapse

AU - Figliozzi, Stefano

AU - Di Maio, Silvana

AU - Georgiopoulos, Georgios

AU - Vandenberk, Bert

AU - Chiribiri, Amedeo

AU - Francone, Marco

AU - Aung, Nay

AU - Petersen, Steffen E.

AU - Leiner, Tim

AU - Bogaert, Jan

AU - Masci, Pier-Giorgio

PY - 2025/1/15

Y1 - 2025/1/15

N2 - With a prevalence of 2–3% in the general population, mitral valve prolapse (MVP) is the most common valvular heart disease. The clinical course is benign in the majority of patients, although severe mitral regurgitation, heart failure, and sudden cardiac death affect a non-negligible subset of patients. Imaging of MVP was confined to echocardiography until a few years ago when it became apparent that cardiovascular magnetic resonance (CMR) could offer comparative advantages for detecting and quantifying mitral valve abnormalities alongside tissue myocardial characterization. The present review highlights the growing body of evidence supporting the role of CMR in patients with MVP. Based on the recent literature, CMR appears not as a simple alternative to echocardiography in patients with poor acoustic windows, but as a complementary imaging modality instrumental for better quantifying mitral valve abnormalities, mitral regurgitation severity, ventricular remodeling, and myocardial tissue changes. In this respect, pivotal CMR studies highlight that mitral annular disjunction and myocardial fibrosis by late gadolinium enhancement are associated with a heightened risk of life-threatening ventricular arrhythmias (arrhythmic MVP). We also delineate how these and other markers (e.g., the severity of mitral regurgitation) could enable a personalized risk assessment in patients with MVP and implement clinical decision-making. Here, we provide a comprehensive review of the current literature, with an emphasis on the arrhythmic MVP phenotype. The review also provides some practical suggestions on how to carry out a dedicated CMR protocol in MVP and composes a thorough report to inform clinicians on key aspects of this valvular heart disease.

AB - With a prevalence of 2–3% in the general population, mitral valve prolapse (MVP) is the most common valvular heart disease. The clinical course is benign in the majority of patients, although severe mitral regurgitation, heart failure, and sudden cardiac death affect a non-negligible subset of patients. Imaging of MVP was confined to echocardiography until a few years ago when it became apparent that cardiovascular magnetic resonance (CMR) could offer comparative advantages for detecting and quantifying mitral valve abnormalities alongside tissue myocardial characterization. The present review highlights the growing body of evidence supporting the role of CMR in patients with MVP. Based on the recent literature, CMR appears not as a simple alternative to echocardiography in patients with poor acoustic windows, but as a complementary imaging modality instrumental for better quantifying mitral valve abnormalities, mitral regurgitation severity, ventricular remodeling, and myocardial tissue changes. In this respect, pivotal CMR studies highlight that mitral annular disjunction and myocardial fibrosis by late gadolinium enhancement are associated with a heightened risk of life-threatening ventricular arrhythmias (arrhythmic MVP). We also delineate how these and other markers (e.g., the severity of mitral regurgitation) could enable a personalized risk assessment in patients with MVP and implement clinical decision-making. Here, we provide a comprehensive review of the current literature, with an emphasis on the arrhythmic MVP phenotype. The review also provides some practical suggestions on how to carry out a dedicated CMR protocol in MVP and composes a thorough report to inform clinicians on key aspects of this valvular heart disease.

KW - Mitral regurgitation

KW - Mitral valve prolapse

KW - Sudden cardiac death

UR - http://www.scopus.com/inward/record.url?scp=85214846884&partnerID=8YFLogxK

U2 - 10.1016/j.jocmr.2024.101137

DO - 10.1016/j.jocmr.2024.101137

M3 - Review article

C2 - 39725235

SN - 1097-6647

VL - 27

JO - Journal of Cardiovascular Magnetic Resonance

JF - Journal of Cardiovascular Magnetic Resonance

IS - 1

M1 - 101137

ER -

Cardiovascular magnetic resonance in patients with mitral valve prolapse

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this