Key result
Mitral valve prolapse is characterized by a lower papillary muscle signal intensity on cine MRI compared to left ventricular myocardium.
Why the study?
Mitral valve prolapse (MVP) may affect papillary muscle (PM) function and structure, prompting investigation into abnormal PM signal using cardiac MRI.
Does cardiac MRI reveal abnormal papillary muscle signal intensity in patients with mitral valve prolapse compared to other cardiac conditions and healthy volunteers?
Cross-Sectional (n=102)
No
Does cardiac MRI reveal abnormal papillary muscle signal intensity in patients with mitral valve prolapse compared to other cardiac conditions and healthy volunteers?
Cardiac MRI reveals a significantly reduced papillary muscle signal intensity ('darker appearance') unique to patients with mitral valve prolapse, which does not appear to be related to myocardial fibrosis or complex ventricular arrhythmias.
Answers are grounded in this paper and cite their sources.
CMR may detect abnormal PM signal in MVP; leaves open its diagnostic specificity and prognostic value.
BACKGROUND: Mitral valve prolapse (MVP) is characterized by an abnormal movement of the valvular apparatus which may affect the papillary muscles (PMs) function and structure. Aim of the study was to investigate abnormal PM signal in MVP by using cardiac magnetic resonance imaging (MRI). METHODS AND RESULTS: We enrolled 47 consecutive patients with MVP evaluated by cardiac MRI. Additional groups included healthy volunteers, patients with moderate-to-severe mitral regurgitation (not caused by MVP) and patients with hypertrophic cardiomyopathy. Visual assessment of the PM signals was carried out and the signal intensity (SI) of both the antero-lateral and postero-medial PMs was normalized by that of the left ventricular (LV) parietal myocardium. Our results show that in the MVP group only, the PM signal intensity was significantly lower compared to the one of the LV parietal myocardium. This sign did not correlate with either LV late gadolinium enhancement or positive anamnesis for significant arrhythmias. CONCLUSIONS: In MVP patients only, PM signal is significantly reduced compared to LV parietal myocardium ("darker appearance"). The described findings are not clearly related to evidence of myocardial fibrosis, as assessed by MRI, and to previous occurrence of complex ventricular arrhythmias.
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Scatteia et al. (2020) conducted a cross-sectional in Mitral valve prolapse (n=102). Mitral valve prolapse vs. Healthy volunteers, mitral regurgitation, and hypertrophic cardiomyopathy was evaluated on Anterior papillary signal (APS) ratio (p=<0.001). Mitral valve prolapse is characterized by a lower papillary muscle signal intensity on cine MRI compared to left ventricular myocardium.
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