Dark-blood late gadolinium enhancement CMR improves detection of papillary muscle fibrosis in patients with mitral valve prolapse

Caroline M Van De Heyning, Robert J Holtackers, Muhummad Sohaib Nazir, Julia Grapsa, Camelia Demetrescu, Lobke Pype, Amedeo Chiribiri

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

PURPOSE: Papillary muscle fibrosis may act as an arrhythmogenic substrate in patients with mitral valve prolapse (MVP). Previous studies used conventional bright-blood late gadolinium enhancement cardiovascular magnetic resonance (LGE CMR) imaging to assess papillary muscle fibrosis, although this technique suffers from poor scar-to-blood contrast which may limit its sensitivity, in contrast to dark-blood LGE. This study sought to compare bright-blood and dark-blood LGE for the detection of papillary muscle fibrosis in patients with MVP.

METHOD: 60 patients with known isolated MVP referred for CMR were prospectively recruited. A routine CMR protocol was used to obtain cine imaging, dark-blood LGE and bright-blood LGE in three long-axis views and a stack of short-axis views. Flow mapping of the proximal aorta was performed to calculate mitral regurgitant volume. Images were analysed for cardiac volumes, ejection fraction, mitral regurgitation severity, MVP characteristics (mitral annular disjunction, prolapse volume) and presence of LGE at the papillary muscles and myocardium.

RESULTS: Dark-blood LGE detected significantly more subjects with LGE at the papillary muscles than bright-blood LGE (35% vs 15%, p = 0.002). There was no difference between LGE techniques regarding myocardial (non-papillary muscle) fibrosis (present in 25% each). No statistical differences were observed between patients with or without LGE at the papillary muscles regarding demographics, clinical data (including ventricular arrhythmia) and MVP characteristics. Furthermore, no association was found between LGE at the papillary muscles and at the myocardium.

CONCLUSIONS: Compared to bright-blood LGE, dark-blood LGE CMR improves the detection of LGE at the papillary muscles in patients with MVP.

Original languageEnglish
Article number110118
JournalEuropean Journal of Radiology
Volume147
Early online date25 Dec 2021
DOIs
Publication statusPublished - Feb 2022

Keywords

  • Cardiovascular magnetic resonance
  • LGE
  • Mitral regurgitation
  • Mitral valve prolapse
  • Papillary muscle fibrosis

Fingerprint

Dive into the research topics of 'Dark-blood late gadolinium enhancement CMR improves detection of papillary muscle fibrosis in patients with mitral valve prolapse'. Together they form a unique fingerprint.

Cite this