- Meeting abstract
- Open Access
2044 Can delayed hyperenhancement shed insight into the mechanism of mitral regurgitation?
© Biederman et al; licensee BioMed Central Ltd. 2008
- Published: 22 October 2008
- Mitral Valve
- Mitral Regurgitation
- Tricuspid Annulus
- Annular Dilatation
A myriad of explanations underpin the mechanisms proposed for the LV annular dilatation following a myocardial infarction that eventually lead to mitral regurgitation. Most believe an active process drives remodeling of adjacent myocardium with subsequent secondary mitral annular dilation. However, non-geometric, passive mechanisms have not been considered as potential contributers to either the mitral valve or the annular patholgy. Classic CMR delayed hyperenhancement (DHE) describes a myriad of LV myocardial histopathology but may also be sensitive to non-myocardial pathology such as the annulus or the mitral leaflets.
We hypothesize that DHE may detect occult LV annular and/or mitral valvular enhancement in post MI patients.
220 patients; 140 s/p MI (55 F, 50 acute, 90 chronic) underwent CMR (1.5 T GE) with 0.2 mmol/kg of Magnevist (Berlex, Montville, New Jersey or 0.1 mmol/kg MultiHance (Bracco Diagnostics, Princeton, New Jersey). Notation of presence or absence of DHE involving the mitral annulus and/or mitral valve was made. Non-MI patientss (80) served as controls.
CMR DHE depicts focal annular and/or valvar enhancement in a large number of post MI patients, suggesting a specific, as yet unknown reactive process may contribute to annular dilatation and/or mitral leaflet pathology. This passive phenomena is currently not a suspected contributor to the post MI phenotype but may portend late LV dilatation and either primary or secondary mitral regurgitation.
The Delayed Hyperenhancement phenomenon has been well described for improved myocardial tissue characterization for infarct and non-infarct related pathologies. We demonstrate that this same property of DHE appears to delineate previously unrecognized properties within the mitral valve in post-MI patients.
This article is published under license to BioMed Central Ltd.