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May 17, 2023Open Access

Mitral valve prolapse patients exhibited a dark-appearance of the papillary muscles with significantly higher native T1 (1096 vs 994 ms) and extracellular volume (33.9% vs 25.9%) compared to healthy volunteers.

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Why the study?

Does cardiovascular magnetic resonance (CMR) imaging of the papillary muscles predict biopsy-proven left ventricular fibrosis in patients with severe mitral valve prolapse?

Population

19 patients with mitral valve prolapse and indication for surgery due to severe mitral regurgitation, and 21…

Comparison

Preoperative cardiovascular magnetic resonance… vs Healthy volunteers and intraoperative LV…

Design

Cross-sectional

Key result

Mitral valve prolapse patients exhibited a dark-appearance of the papillary muscles with significantly higher native T1 (1096 vs 994 ms) and extracellular volume (33.9% vs 25.9%) compared to healthy volunteers.

Authors

RSRicardo A. SpampinatoMCMateo Marin CuartasAKAntonia van Kampen

Discussion

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Member takes

Overview

DB-LGE at posteromedial PM on CMR was associated with biopsy-proven LV fibrosis in surgical MVP; hypothesis-generating for noninvasive detection, prospective validation needed.

Study Design

Type

Cross-Sectional (n=40)

Blinding

Blinded to clinical and echocardiographic data

Multicenter

No

Structured PICO

Does cardiovascular magnetic resonance (CMR) imaging of the papillary muscles predict biopsy-proven left ventricular fibrosis in patients with severe mitral valve prolapse?

P
Population
19 patients with mitral valve prolapse and severe mitral regurgitation referred for surgery, and 21 healthy volunteers, underwent comprehensive cardiovascular magnetic resonance tissue characterization.
E
Exposure
Preoperative cardiovascular magnetic resonance (CMR) imaging with characterization of the papillary muscles (dark-appearance on cine, T1 mapping, conventional bright blood [BB] and dark blood [DB] late gadolinium enhancement [LGE]).
C
Comparator
Healthy volunteers (for CMR T1 mapping) and intraoperative LV inferobasal myocardial biopsies (as reference standard for fibrosis).
O
Outcome
Association of CMR tissue characterization of the papillary muscles with LV fibrosis observed by intraoperative biopsies.surrogate

Main Result

Absolute Event Rate: 1096% vs 994%

p-value: p=<0.001

Dark blood late gadolinium enhancement CMR of the posteromedial papillary muscle may serve as a better predictor of biopsy-proven LV inferobasal fibrosis than conventional CMR techniques in patients with severe mitral valve prolapse.

Limitations

  • Small sample size leading to potential type II errors
  • Not powered or designed to assess the relationship of the results with MVP subtypes or clinical characteristics like ventricular arrhythmias
  • Histological findings might be limited by sampling error
  • Cross-sectional study design limits causal inferences

Cite This Study

Spampinato et al. (2023) conducted a cross-sectional in Mitral valve prolapse with severe mitral regurgitation (n=40). Mitral valve prolapse vs. Healthy volunteers was evaluated on Papillary muscle native T1 (p=<0.001). Mitral valve prolapse patients exhibited a dark-appearance of the papillary muscles with significantly higher native T1 (1096 vs 994 ms) and extracellular volume (33.9% vs 25.9%) compared to healthy volunteers.

synapsesocial.com/papers/6ab3847e662930bdfbe34c2ehttps://doi.org/10.21203/rs.3.rs-2936590/v1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Abnormal Papillary Muscle Signal on Cine MRI As a Typical Feature of Mitral Valve Prolapse2020 · 18 citations
  2. 2Left ventricular remodelling in mitral valve prolapse patients: implications of apical papillary muscle insertion2021 · 11 citations
  3. 3Dark-blood late gadolinium enhancement CMR improves detection of papillary muscle fibrosis in patients with mitral valve prolapse2021 · 17 citations
  4. 4Multimodal evaluation for predicting myocardial fibrosis and ventricular arrhythmias in patients with mitral valve prolapse: limited utility of clinical, echocardiographic and CMR parameters2026
  5. 5Histopathological insights into mitral valve prolapse-induced fibrosis2023 · 9 citations