Rapid Fire Abstracts
Jeffrey Ji-Peng Li, MD
Student
Charité Universitätsmedizin Berlin, Germany
Jeffrey Ji-Peng Li, MD
Student
Charité Universitätsmedizin Berlin, Germany
Patrick Doeblin, MD
Cardiologist
Deutsches Herzzentrum der Charité, Germany
Stefanie M. Werhahn, MD
Cardiologist
Deutsches Herzzentrum der Charité, Germany
Shing Ching
United Christian Hopsital, Germany
Rebecca E. Beyer, MD
Resident
Deutsches Herzzentrum der Charité, Germany
Misael Estepa, MD
Resident
Deutsches Herzzentrum der Charité, Germany
Christian Stehning, PhD
MRI Physicist
Philips Healthcare, Germany
Djawid Hashemi, MD, MSc
Cardiologist
Deutsches Herzzentrum der Charité, Germany
Natalia Solowjowa, MD
Consultant
Deutsches Herzzentrum der Charité, Germany
Henryk Dreger, MD
Head of Department
Deutsches Herzzentrum der Charité, Germany
Sebastian Kelle, MD, FSCMR
Cardiologist
Deutsches Herzzentrum der Charité, Germany
Although mitral valve prolapse (MVP) was initially described over 100 years ago, its etiology, pathophysiology, and prognostic factors are still insufficiently understood. It is known from echocardiographic observations that the regional contraction pattern, especially in the inferolateral segments, is altered in patients with MVP. With cardiovascular magnetic resonance (CMR) becoming increasingly important in the evaluation of global and regional cardiac function, we aimed to quantify the regional contraction patterns of the inferolateral segments with CMR Feature-Tracking-Strain-Analysis in patients with MVP and a healthy control group to investigate any differences between those groups.
Methods:
Of patients who underwent clinical CMR scans from 2013 to 2023, 111 subjects with MVP were identified and compared to a control group of 50 healthy subjects from previous studies. All CMR scans were performed on 1.5T (Achieva/Ambition, Philips Healthcare, Best, The Netherlands) and 3T (Ingenia, Philips Healthcare, Best, The Netherlands) scanners with multi-element phased-array coils. Feature-tracking endocardial strain-analysis was performed on long axis cine balanced steady-state free precession (bSSFP) images (2-, 3- and 4-chamber-view) of both groups to assess left ventricular (LV) global circumferential strain (GCS) and global longitudinal strain (GLS), peak regional longitudinal strain in the basal (S5) and medial (S11) inferolateral segments of the heart, left atrial (LA) GLS, and right ventricular (RV) free wall longitudinal strain. Strain measurements were performed semi-automatically using dedicated postprocessing software (QStrain© 4.1, Medis Medical Systems bv, Leiden, The Netherlands). The retrospective study was approved by the local ethics committee and registered in the german register for clinical trials (DRKS00033713).
Results:
Baseline characteristics did not differ between the two groups except for sex and age (Table 1). Among the CMR standard parameters, significant differences were observed in the LV end-diastolic volume index (LVEDVi), LV end-systolic volume index (LVESVi), and LV stroke volume index (LVSVi) between healthy subjects and patients with MVP (Table 2). In the strain analysis, significant differences were found in the regional peak longitudinal strain values of S5 and S11 as well as LA GLS between healthy subjects and patients with MVP (Figure 1). There was no correlation between these parameters and either age or sex. No significant differences were found in the other assessed strain parameters.
Conclusion:
Patients with MVP showed slightly worse LA GLS and regional longitudinal strain in the inferolateral basal segment of the myocardium, but better regional longitudinal strain in the inferolateral medial segment compared to healthy subjects. LV GCS, LV GLS, and RV free wall longitudinal strain did not differ between the two groups.
