Author + information
- Danai Kitkungvana,b,
- Faisal Nabia,b,
- Mohamamd Khana,b,
- Jiaqiong Xua,b,
- Eric Yanga,b and
- Dipan Shaha,b
Background: CMR is able to directly detect regional replacement fibrosis [via late gadolinium enhancement (LGE)] and infers diffuse interstitial fibrosis [via extracellular volume fraction (ECV)]. We sought to evaluate the prevalence and associated factors with these forms of fibrosis in patient with chronic primary mitral regurgitation (MR).
Methods: Patients referred for CMR to assess chronic MR were enrolled. Confounding causes of LGE (CAD, LVEF <50%, etc) and secondary MR were excluded. Primary MR patients were classified into MVP and non-MVP groups. LGE-CMR was used to identify regional replacement fibrosis. T1-mapping (modified Look-Locker inversion recovery) was performed pre and post gadolinium contrast administration to calculate ECV.
Results: We studied 192 primary MR patients (98 MVP, and 94 non-MVP). LGE was more prevalent in patients with MVP (19.8% vs. 2.6%, p<0.001), particularly in basal inferolateral wall. ECV increased with MR severity in both groups (Panel A). On multivariate analysis, LGE presence was associated with MVP, but not with MR severity (Panel B). In contrast, by multivariate linear regression model, increasing ECV was associated with increased LA size and MR severity, but not with MVP (Panel B).
Conclusions: Patients with chronic primary MR exhibit distinct forms of fibrosis: regional replacement fibrosis that is uniquely associated with MVP, and diffuse interstitial fibrosis that is associated with MR severity, independent of MR etiology.
Room 204 A
Sunday, March 19, 2017, 8:25 a.m.-8:35 a.m.
Session Title: Highlighted Original Research: Valvular Heart Disease and the Year in Review
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 912-06
- 2017 American College of Cardiology Foundation