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CMR in evaluation of mitral regurgitation

Pei G Chew, Katrina Bounford, Sven Plein, Dominik Schlosshan, John P Greenwood
The natural history of mitral regurgitation (MR) results in significant morbidity and mortality. Innovations in non-invasive imaging have provided new insights into the pathophysiology and quantification of MR, in addition to early detection of left ventricular (LV) dysfunction and prognostic assessment in asymptomatic patients. Transthoracic (TTE) and transesophageal (TOE) echocardiography are the mainstay for diagnosis, assessment and serial surveillance. However, the advance from 2D to 3D imaging leads to improved assessment and characterization of mitral valve (MV) disease...
April 2018: Quantitative Imaging in Medicine and Surgery
G S Gulsin, A Singh, G P McCann
BACKGROUND: Over the last 25 years, cardiovascular magnetic resonance imaging (CMR) has emerged as an alternative to echocardiography for assessment of valvular heart disease (VHD). Although echo remains the first-line imaging modality for the assessment of patients with VHD, CMR can now provide a comprehensive assessment in many instances. Using a combination of techniques, CMR provides information on valve anatomy and enables quantitative analysis of the severity of the valve lesion...
December 29, 2017: BMC Medical Imaging
Marc-André Bouchard, Claudia Côté-Laroche, Jonathan Beaudoin
Mitral regurgitation (MR) is frequent and associated with increased mortality and morbidity when severe. It may be caused by intrinsic valvular disease (primary MR) or ventricular deformation (secondary MR). Imaging has a critical role to document the severity, mechanism, and impact of MR on heart function as selected patients with MR may benefit from surgery whereas other will not. In patients planned for a surgical intervention, imaging is also important to select candidates for mitral valve (MV) repair over replacement and to predict surgical success...
October 13, 2017: Current Treatment Options in Cardiovascular Medicine
Frank E Corrigan, Aneel Maini, Shawn Reginauld, Stamatios Lerakis
Mitral regurgitation is one of the more common forms of valvular heart disease. Given the expansion of therapies for structural heart disease, new therapies for mitral regurgitation are emerging. An accurate description and classification of mitral disease is important to understand pathology and provide recommendations for therapy. Areas covered: In the modern evaluation of mitral regurgitation, 3-dimensional echocardiography (3DE) and cardiac magnetic resonance imaging (CMR) play important roles which overcome the prior limitations of 2-dimensional echocardiography...
September 2017: Expert Review of Cardiovascular Therapy
Tomaz Podlesnikar, Victoria Delgado, Jeroen J Bax
The left ventricular (LV) remodeling process associated with significant valvular heart disease (VHD) is characterized by an increase of myocardial interstitial space with deposition of collagen and loss of myofibers. These changes occur before LV systolic function deteriorates or the patient develops symptoms. Cardiovascular magnetic resonance (CMR) permits assessment of reactive fibrosis, with the use of T1 mapping techniques, and replacement fibrosis, with the use of late gadolinium contrast enhancement...
January 2018: International Journal of Cardiovascular Imaging
Neil K Mehta, Jiwon Kim, Jonathan Y Siden, Sara Rodriguez-Diego, Javid Alakbarli, Antonino Di Franco, Jonathan W Weinsaft
Mitral regurgitation (MR) is a common cause of morbidity worldwide and an accepted indication for interventional therapies which aim to reduce or resolve adverse clinical outcomes associated with MR. Cardiac magnetic resonance (CMR) provides highly accurate means of assessing MR, including a variety of approaches that can measure MR based on quantitative flow. Additionally, CMR is widely accepted as a reference standard for cardiac chamber quantification, enabling reliable detection of subtle changes in cardiac chamber size and function so as to guide decision-making regarding timing of mitral valve directed therapies...
April 2017: Journal of Thoracic Disease
Tomas Lapinskas, Paulius Bučius, Laura Urbonaitė, Agnieta Stabinskaitė, Živilė Valuckienė, Lina Jankauskaitė, Rimantas Benetis, Remigijus Žaliūnas
BACKGROUND AND OBJECTIVE: Left atrium (LA) is an important biomarker of adverse cardiovascular outcomes and cerebrovascular events. This study aimed to evaluate LA myocardial deformation using cardiac magnetic resonance feature tracking (CMR-FT) in patients with acute ST-segment elevation myocardial infarction (STEMI) and secondary mitral regurgitation (MR). Additionally, to assess interobserver and intraobserver variability of the technique. MATERIALS AND METHODS: Twenty patients with STEMI underwent CMR with a 1...
2017: Medicina
Jeroen J Bax, Victoria Delgado
Although echocardiography remains the mainstay imaging technique for the evaluation of patients with valvular heart disease (VHD), innovations in noninvasive imaging in the past few years have provided new insights into the pathophysiology and quantification of VHD, early detection of left ventricular (LV) dysfunction, and advanced prognostic assessment. The severity grading of valve dysfunction has been refined with the use of Doppler echocardiography, cardiac magnetic resonance (CMR), and CT imaging. LV ejection fraction remains an important criterion when deciding whether patients should be referred for surgery...
April 2017: Nature Reviews. Cardiology
Eric V Krieger, James Lee, Kelley R Branch, Christian Hamilton-Craig
In this review discuss the application of cardiac magnetic resonance (CMR) to the evaluation and quantification of mitral regurgitation and provide a systematic literature review for comparisons with echocardiography. Using the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, we searched Medline and PubMed for original research articles published since 2000 that provided data on the quantification of mitral regurgitation by CMR. We identified 220 articles of which 33 were included...
December 1, 2016: Heart: Official Journal of the British Cardiac Society
Mark Aplin, Kasper Kyhl, Jenny Bjerre, Nikolaj Ihlemann, John P Greenwood, Sven Plein, Akhlaque Uddin, Niels Tønder, Nis Baun Høst, Malin Glindvad Ahlström, Jens Hove, Christian Hassager, Kasper Iversen, Niels G Vejlstrup, Per Lav Madsen
AIMS: Evaluation of patients with primary mitral valve insufficiency (MI) is best supported by quantitative measures. Cardiovascular magnetic resonance imaging (CMR) offers flow and cardiac chamber volume quantification. We studied cardiac remodelling with CMR to determine MI regurgitation volumes (MIVol) related to severe MI. METHODS AND RESULTS: In total, 24, 20, and 28 patients determined to have mild, moderate, and severe primary MI, respectively, were studied...
August 2016: European Heart Journal Cardiovascular Imaging
Juan C Lopez-Mattei, Homam Ibrahim, Kamran A Shaikh, Stephen H Little, Dipan J Shah, Dimitrios Maragiannis, William A Zoghbi
Although transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) are validated in quantitation of mitral regurgitation (MR), discrepancies may occur. This study assesses the agreement between TTE and CMR in MR and evaluates characteristics and clinical outcome of patients with discrepancy. From our institutional database, 70 subjects with MR underwent both TTE and CMR within 30 days (median 3 days). MR was evaluated semiquantitatively (n = 70) using a 4-grade scale and quantitatively (n = 60) with calculation of regurgitant volume (RVol) and regurgitant fraction (RF)...
January 15, 2016: American Journal of Cardiology
Christian Hamilton-Craig, Wendy Strugnell, Niranjan Gaikwad, Matthew Ischenko, Vicki Speranza, Jonathan Chan, Johanne Neill, David Platts, Gregory M Scalia, Darryl J Burstow, Darren L Walters
OBJECTIVE: Percutaneous valve intervention for severe mitral regurgitation (MR) using the MitraClip is a novel technology. Quantitative assessment of residual MR by transthoracic echocardiography (TTE) is challenging, with multiple eccentric jets and artifact from the clips. Cardiovascular magnetic resonance (CMR) is the reference standard for left and right ventricular volumetric assessment. CMR phase-contrast flow imaging has superior reproducibility for quantitation of MR compared to echocardiography...
July 2015: Annals of Cardiothoracic Surgery
Christophe de Meester de Ravenstein, Caroline Bouzin, Siham Lazam, Jamila Boulif, Mihaela Amzulescu, Julie Melchior, Agnès Pasquet, David Vancraeynest, Anne-Catherine Pouleur, Jean-Louis J Vanoverschelde, Bernhard L Gerber
BACKGROUND: Gadolinium (Gd) Extracellular volume fraction (ECV) by Cardiovascular Magnetic Resonance (CMR) has been proposed as a non-invasive method for assessment of diffuse myocardial fibrosis. Yet only few studies used 3 T CMR to measure ECV, and the accuracy of ECV measurements at 3 T has not been established. Therefore the aims of the present study were to validate measurement of ECV by MOLLI T1 mapping by 3 T CMR against fibrosis measured by histopathology. We also evaluated the recently proposed hypothesis that native-T1 mapping without contrast injection would be sufficient to detect fibrosis...
June 11, 2015: Journal of Cardiovascular Magnetic Resonance
Shweta R Motiwala, Francesca N Delling
Mitral valve disease (MVD) related to mitral valve prolapse (MVP), coronary artery disease (CAD), and calcific mitral stenosis, is increasing in prevalence across the USA and Europe in the context of a longer life expectancy and aging population. In developing countries, rheumatic heart disease remains a major cause of MVD. Echocardiography represents the primary diagnostic modality for assessment of the mitral valve (MV). With the implementation of three-dimensional imaging, echocardiography has become an indispensable tool to evaluate the morphology, geometry, and function of the MV apparatus in the pre-operative setting...
July 2015: Current Treatment Options in Cardiovascular Medicine
Lauren A Simprini, Anika Afroz, Mitchell A Cooper, Igor Klem, Christoph Jensen, Raymond J Kim, Monvadi B Srichai, John F Heitner, Michael Sood, Elizabeth Chandy, Dipan J Shah, Juan Lopez-Mattei, Robert W Biederman, John D Grizzard, Anthon Fuisz, Kambiz Ghafourian, Afshin Farzaneh-Far, Jonathan Weinsaft
BACKGROUND AND AIM OF THE STUDY: Mitral regurgitation (MR) is an important complication after prosthetic mitral valve (PMV) implantation. Transthoracic echocardiography is widely used to screen for native MR, but can be limited with PMV. Cine-cardiac magnetic resonance (CMR) holds the potential for the non-invasive assessment of regurgitant severity based on MR-induced inter-voxel dephasing. The study aim was to evaluate routine cine-CMR for the visual assessment of PMV-associated MR...
September 2014: Journal of Heart Valve Disease
Nicolas Brugger, Kerstin Wustmann, Michael Hürzeler, Andreas Wahl, Stefano F de Marchi, Hélène Steck, Fabian Zürcher, Christian Seiler
The aim of our study was to evaluate 3-dimensional (3D) color Doppler proximal isovelocity surface area (PISA) as a tool for quantitative assessment of mitral regurgitation (MR) against in vitro and in vivo reference methods. A customized 3D PISA software was validated in vitro against a flowmeter MR phantom. Sixty consecutive patients, with ≥mild MR of any cause, were recruited and the regurgitant volume (RVol) was measured by 2D PISA, 3D peak PISA, and 3D integrated PISA, using transthoracic (TTE) and transesophageal echocardiography (TEE)...
April 15, 2015: American Journal of Cardiology
You-Zhou Chen, Fu-Jian Duan, Jian-Song Yuan, Feng-Huan Hu, Jin-Gang Cui, Wei-Xian Yang, Yan Zhang, Hao Wang, Shu-Bin Qiao
Alcohol septal ablation (ASA) has been shown to improve left ventricular (LV) diastolic function in patients with obstructive hypertrophic cardiomyopathy (HCM). However, its beneficial effect on diastolic function assessed by cardiac magnetic resonance (CMR) has not been reported. We investigated the mid-term changes of diastolic function by CMR combined with echocardiography in HCM patients after ASA at a median of 14-month follow-up. CMR parameters of diastolic function including peak filling rate (PFR), and time to peak filling rate (TPFR) were evaluated in 43 patients (aged 48 ± 9 years)...
May 2016: Heart and Vessels
Christopher Howell Critoph, Antonios Pantazis, Maria Teresa Tome Esteban, Joel Salazar-Mendiguchía, Efstathios D Pagourelias, James C Moon, Perry Mark Elliott
OBJECTIVES: Aortoseptal angulation (AoSA) can predict provocable left ventricular outflow tract obstruction (LVOTO) in patients with symptomatic hypertrophic cardiomyopathy (HCM). Lack of a standardised measurement technique in HCM without the need for complex three-dimensional (3D) imaging limits its usefulness in routine clinical practice. This study aimed to validate a simple measurement of AoSA using 2D echocardiography and cardiac MR (CMR) imaging as a predictor of LVOTO. METHODS: We retrospectively assessed 160 patients with non-obstructive HCM, referred for exercise stress echocardiography...
2014: Open Heart
Kongkiat Chaikriangkrai, Juan C Lopez-Mattei, Gerald Lawrie, Homam Ibrahim, Miguel A Quinones, William Zoghbi, Stephen H Little, Dipan J Shah
BACKGROUND: The objective of this study was to examine the prognostic utility of cardiac magnetic resonance imaging (CMR) in patients with chronic mitral regurgitation undergoing mitral valve repair. METHODS: This study is a prospectively enrolled observational cohort study of 48 consecutive patients with chronic mitral regurgitation who had preoperative evaluation with CMR including delayed-enhancement CMR for assessment of myocardial fibrosis before undergoing mitral valve repair...
November 2014: Annals of Thoracic Surgery
João L Cavalcante, Thomas H Marwick, Rory Hachamovitch, Zoran B Popovic, Nael Aldweib, Randall C Starling, Milind Y Desai, Scott D Flamm, Deborah H Kwon
UNLABELLED: Cardiac magnetic resonance (CMR) identifies important prognostic variables in ischemic cardiomyopathy (ICM) patients such as left ventricular (LV) volumes, LV ejection fraction (LVEF), peri-infarct zone, and myocardial scar burden (MSB). It is unknown whether Doppler-based diastolic dysfunction (DDF) retains its prognostic value in ICM patients, in the context of current imaging, medical, and device therapies. METHODS: Diastolic function was evaluated in ICM patients (LVEF ≤ 40% and ≥ 70% stenosis in ≥ 1 coronary artery) who underwent transthoracic echocardiogram and delayed hyperenhancement CMR studies within 7 days...
August 2014: American Heart Journal
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