Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging (2024)

Abstract

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. Combining cine stacks with phase-contrast velocity mapping across the ascending aorta, CMR-determined MIVol was reproducibly obtained as the difference between left ventricular (LV) stroke volume and aortic forward flow (Aoflow). With increasing MI severity, MIVol, left heart volumes, and pulmonary venous diameters increased (P < 0.01). Severe MI with LV end-systolic diameter of 40 mm was signified by MIVol >40 mL, MI regurgitant fraction >0.30, LV end-diastolic volume (LVEDV(i)) >108 mL m(-2), and a total left heart volume >188 mL m(-2) with dilated pulmonary veins and a LVEDV/right ventricular EDV ratio >1.2. In severe MI, LV ejection fraction was unaffected, but the Aoflow and the peak ejection rate indexed to LVEDV were lowered (P < 0.05). In surgical patients, the MIVol correlated to the decrease in LV dimension after valve surgery (P < 0.02).

CONCLUSION: CMR provides a reproducible quantitative technique for evaluation of MI, as MIVol and cardiac chamber volumes can be held against diagnostic cut-off values. The Aoflow and peak ejection rate indexed to LVEDV may reveal early LV systolic dysfunction in patients with severe MI. Severe MI is related to lower MI regurgitation volume and fraction than previously believed.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal Cardiovascular Imaging
Vol/bind17
Udgave nummer8
Sider (fra-til)863-870
Antal sider8
ISSN2047-2404
DOI
StatusUdgivet - 2016

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Aplin, M., Kyhl, K., Bjerre, J., Ihlemann, N., Greenwood, J. P., Plein, S., Uddin, A., Tønder, N., Høst, N. B., Ahlström, M. G., Hove, J., Hassager, C., Iversen, K., Vejlstrup, N. G., & Madsen, P. L. (2016). Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging. European Heart Journal Cardiovascular Imaging, 17(8), 863-870. https://doi.org/10.1093/ehjci/jev321

Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging. / Aplin, Mark; Kyhl, Kasper; Bjerre, Jenny; Ihlemann, Nikolaj; Greenwood, John P; Plein, Sven; Uddin, Akhlaque; Tønder, Niels; Høst, Nis Baun; Ahlström, Malin Glindvad; Hove, Jens; Hassager, Christian; Iversen, Kasper; Vejlstrup, Niels G.; Madsen, Per Lav.

I: European Heart Journal Cardiovascular Imaging, Bind 17, Nr. 8, 2016, s. 863-870.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Aplin, M, Kyhl, K, Bjerre, J, Ihlemann, N, Greenwood, JP, Plein, S, Uddin, A, Tønder, N, Høst, NB, Ahlström, MG, Hove, J, Hassager, C, Iversen, K, Vejlstrup, NG & Madsen, PL 2016, 'Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging', European Heart Journal Cardiovascular Imaging, bind 17, nr. 8, s. 863-870. https://doi.org/10.1093/ehjci/jev321

Aplin M, Kyhl K, Bjerre J, Ihlemann N, Greenwood JP, Plein S et al. Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging. European Heart Journal Cardiovascular Imaging. 2016;17(8):863-870. https://doi.org/10.1093/ehjci/jev321

Aplin, Mark ; Kyhl, Kasper ; Bjerre, Jenny ; Ihlemann, Nikolaj ; Greenwood, John P ; Plein, Sven ; Uddin, Akhlaque ; Tønder, Niels ; Høst, Nis Baun ; Ahlström, Malin Glindvad ; Hove, Jens ; Hassager, Christian ; Iversen, Kasper ; Vejlstrup, Niels G. ; Madsen, Per Lav. / Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging. I: European Heart Journal Cardiovascular Imaging. 2016 ; Bind 17, Nr. 8. s. 863-870.

@article{9d46997689764c108315cc5b672107e1,

title = "Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging",

abstract = "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. Combining cine stacks with phase-contrast velocity mapping across the ascending aorta, CMR-determined MIVol was reproducibly obtained as the difference between left ventricular (LV) stroke volume and aortic forward flow (Aoflow). With increasing MI severity, MIVol, left heart volumes, and pulmonary venous diameters increased (P < 0.01). Severe MI with LV end-systolic diameter of 40 mm was signified by MIVol >40 mL, MI regurgitant fraction >0.30, LV end-diastolic volume (LVEDV(i)) >108 mL m(-2), and a total left heart volume >188 mL m(-2) with dilated pulmonary veins and a LVEDV/right ventricular EDV ratio >1.2. In severe MI, LV ejection fraction was unaffected, but the Aoflow and the peak ejection rate indexed to LVEDV were lowered (P < 0.05). In surgical patients, the MIVol correlated to the decrease in LV dimension after valve surgery (P < 0.02).CONCLUSION: CMR provides a reproducible quantitative technique for evaluation of MI, as MIVol and cardiac chamber volumes can be held against diagnostic cut-off values. The Aoflow and peak ejection rate indexed to LVEDV may reveal early LV systolic dysfunction in patients with severe MI. Severe MI is related to lower MI regurgitation volume and fraction than previously believed.",

author = "Mark Aplin and Kasper Kyhl and Jenny Bjerre and Nikolaj Ihlemann and Greenwood, {John P} and Sven Plein and Akhlaque Uddin and Niels T{\o}nder and H{\o}st, {Nis Baun} and Ahlstr{\"o}m, {Malin Glindvad} and Jens Hove and Christian Hassager and Kasper Iversen and Vejlstrup, {Niels G.} and Madsen, {Per Lav}",

note = "Published on behalf of the European Society of Cardiology. All rights reserved. {\textcopyright} The Author 2016. For permissions please email: [emailprotected].",

year = "2016",

doi = "10.1093/ehjci/jev321",

language = "English",

volume = "17",

pages = "863--870",

journal = "European Heart Journal Cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

number = "8",

}

TY - JOUR

T1 - Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging

AU - Aplin, Mark

AU - Kyhl, Kasper

AU - Bjerre, Jenny

AU - Ihlemann, Nikolaj

AU - Greenwood, John P

AU - Plein, Sven

AU - Uddin, Akhlaque

AU - Tønder, Niels

AU - Høst, Nis Baun

AU - Ahlström, Malin Glindvad

AU - Hove, Jens

AU - Hassager, Christian

AU - Iversen, Kasper

AU - Vejlstrup, Niels G.

AU - Madsen, Per Lav

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: [emailprotected].

PY - 2016

Y1 - 2016

N2 - 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. Combining cine stacks with phase-contrast velocity mapping across the ascending aorta, CMR-determined MIVol was reproducibly obtained as the difference between left ventricular (LV) stroke volume and aortic forward flow (Aoflow). With increasing MI severity, MIVol, left heart volumes, and pulmonary venous diameters increased (P < 0.01). Severe MI with LV end-systolic diameter of 40 mm was signified by MIVol >40 mL, MI regurgitant fraction >0.30, LV end-diastolic volume (LVEDV(i)) >108 mL m(-2), and a total left heart volume >188 mL m(-2) with dilated pulmonary veins and a LVEDV/right ventricular EDV ratio >1.2. In severe MI, LV ejection fraction was unaffected, but the Aoflow and the peak ejection rate indexed to LVEDV were lowered (P < 0.05). In surgical patients, the MIVol correlated to the decrease in LV dimension after valve surgery (P < 0.02).CONCLUSION: CMR provides a reproducible quantitative technique for evaluation of MI, as MIVol and cardiac chamber volumes can be held against diagnostic cut-off values. The Aoflow and peak ejection rate indexed to LVEDV may reveal early LV systolic dysfunction in patients with severe MI. Severe MI is related to lower MI regurgitation volume and fraction than previously believed.

AB - 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. Combining cine stacks with phase-contrast velocity mapping across the ascending aorta, CMR-determined MIVol was reproducibly obtained as the difference between left ventricular (LV) stroke volume and aortic forward flow (Aoflow). With increasing MI severity, MIVol, left heart volumes, and pulmonary venous diameters increased (P < 0.01). Severe MI with LV end-systolic diameter of 40 mm was signified by MIVol >40 mL, MI regurgitant fraction >0.30, LV end-diastolic volume (LVEDV(i)) >108 mL m(-2), and a total left heart volume >188 mL m(-2) with dilated pulmonary veins and a LVEDV/right ventricular EDV ratio >1.2. In severe MI, LV ejection fraction was unaffected, but the Aoflow and the peak ejection rate indexed to LVEDV were lowered (P < 0.05). In surgical patients, the MIVol correlated to the decrease in LV dimension after valve surgery (P < 0.02).CONCLUSION: CMR provides a reproducible quantitative technique for evaluation of MI, as MIVol and cardiac chamber volumes can be held against diagnostic cut-off values. The Aoflow and peak ejection rate indexed to LVEDV may reveal early LV systolic dysfunction in patients with severe MI. Severe MI is related to lower MI regurgitation volume and fraction than previously believed.

U2 - 10.1093/ehjci/jev321

DO - 10.1093/ehjci/jev321

M3 - Journal article

C2 - 26758406

VL - 17

SP - 863

EP - 870

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

SN - 2047-2404

IS - 8

ER -

Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging (2024)

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