Prognostic Value of Delayed Enhancement Cardiac Magnetic Resonance Imaging in Mitral Valve Repair

Chaikriangkrai, Kongkiat; Lopez‐Mattei, Juan; Lawrie, Gerald M.; Ibrahim, Homam; Quiñones, Miguel Á.; Zoghbi, William A.; Little, Stephen H.; Shah, Dipan J.

doi:10.1016/j.athoracsur.2014.06.049

Cited by 21 publications

(14 citation statements)

References 26 publications

(29 reference statements)

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“…This issue is already established in coronary heart disease and aortic valve abnormality. [11][12][13] Chaikriangkrai et al published a paper regarding prognostic value of LGE after mitral valve surgery. The subjects of the research were patients with chronic mitral regurgitation whose myocardial fibrosis was predominantly caused by myocardial infarction due to coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

“…This particular notion is applicable to myocardial fibrosis which was caused by various etiology, such as aortic valve disease and coronary heart disease. [11][12][13] However, there is currently no published research investigating myocardial fibrosis in rheumatic MS. This research is performed to investigate the relationship of myocardial fibrosis with postoperative morbidity after mitral valve surgery in patients with rheumatic MS. Our hypothesis was that patients with more extensive left ventricular myocardial fibrosis would have increased risk of postoperative morbidity.…”

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confidence: 99%

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Prognostic Value of Late Gadolinium Enhancement in Postoperative Morbidity following Mitral Valve Surgery in Rheumatic Mitral Stenosis

et al. 2019

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Myocardial fibrosis in rheumatic mitral stenosis (MS) is caused by chronic inflammatory process. Its occurrence may lead to hemodynamic problems, especially after cardiac surgery. Myocardial fibrosis predicts worse morbidity after cardiac surgery, notably in coronary heart disease and aortic valve abnormalities. However, this issue has not been explored yet among patients with rheumatic MS.The aim of the study was to investigate prognostic impact of myocardial fibrosis to postoperative morbidity after mitral valve surgery in patients with rheumatic MS.This is a prospectively enrolled observational study of 47 consecutive rheumatic MS patients. All patients had preoperative evaluation with cardiac magnetic resonance imaging (CMR) including late gadolinium enhancement (LGE) protocol for left ventricular myocardial fibrosis assessment prior to mitral valve surgery. All patients were followed during hospitalization period. Postoperative morbidities were defined as stroke, renal failure, and prolonged mechanical ventilation.This study involved 33 women (70.2%) and 14 men (29.8%) with a mean age of 46 ± 10 years. Preoperative myocardial fibrosis was identified in 43 patients (91.5%). Estimated fibrosis volume ranged from 0% to 12.8% (median 2.8%). Postoperative morbidities occurred in 11 patients (23.4%). Significant mean difference of myocardial fibrosis volume was observed between patients with and without morbidity after mitral valve surgery (5.97 ± 4.16% and 3.12 ± 2.62%, p = 0.04). This significant association was allegedly influenced by different postoperative hemodynamic changes between the two groups.More extensive myocardial fibrosis is associated with postoperative morbiditiy after mitral valve surgery in patients with rheumatic MS.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Prognostic Value of Late Gadolinium Enhancement in Postoperative Morbidity following Mitral Valve Surgery in Rheumatic Mitral Stenosis

et al. 2019

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“…In the case of a poor acoustic window or contraindications to TEE, it can be especially helpful for assessing the volume and function of the left ventricle, or evaluation of the severity of valvular regurgitation [1]. Chaikriangkrai et al [7] used CMR to assess the presence of myocardial fibrosis as a negative predictor after mitral repair.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography angiography for imaging results of neochordal mitral valve repair

Zwoliński

Marcinkiewicz

Szymczyk

et al. 2017

kitp

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IntroductionDegenerative mitral regurgitation is currently the most frequent indication for mitral valve repair.AimTo visualize and assess the mid-term results of mitral valve repair with neochordae implantation, using computed tomography angiography (CTA) imaging.Material and methodsThe CTA with ECG gating and without modulation was applied in 10 patients to assess the results of a mitral valve sparing procedure. The results of 3 patients are presented. The patients were operated on for severe symptomatic degenerative mitral regurgitation, defined according to a modified Carpentier’s functional classification.ResultsNeochordal repair, by placing expanded polytetrafluoroethylene sutures between the leading edge of the prolapsing segment and the corresponding papillary muscle, was conducted. From 1 to 3 double Gore-Tex loops were used. Leaflet clefts, if present, were sutured. All repairs included mitral valve ring annuloplasty. The CTA was performed at 20–24 months after the surgery. Long-axis views, reconstructed during mid-systole, seemed to be the most valuable. Good quality cardiac images, precisely presenting the mitral valve complex with its constituents, were obtained in the case of patients without obesity, with a relatively small anterior-posterior thorax dimension, with sinus, slow heart rhythm and quite good left ventricle contractility. The evaluation of the mitral valve included presence of calcifications, fibrosis or thickening, chordal insertion and coaptation points, and papillary muscle locations. Primary and secondary native chordae tendineae and artificial chordae were visualized.ConclusionsContrast material-enhanced ECG-gated CTA applied after mitral valve repair with Gore-Tex neochordae allows one to obtain satisfactory mitral valve images, especially during mid-systole, and evaluate mid-term results of the surgery in chosen patients.

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“…A few studies have shown that the presence of preoperative myocardial fibrosis assessed with LGE-CMR was an independent predictor of increased adverse clinical outcomes in patients with chronic degenerative mitral regurgitation [60,61]. Chaikriangkrai et al [61] reported that preoperative LGE may be of clinical utility for the prediction of outcomes during perimitral valve repair.…”

Section: Mitral Regurgitation and Aortic Regurgitationmentioning

confidence: 99%

“…Chaikriangkrai et al [61] reported that preoperative LGE may be of clinical utility for the prediction of outcomes during perimitral valve repair. Myocardial ECV was increased (32±7% vs. 25±2%, p<0.01) in severe mitral regurgitation patients compared to healthy controls.…”

Section: Mitral Regurgitation and Aortic Regurgitationmentioning

confidence: 99%

The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

Choi

Park

Kim

2017

Cardiovasc Imaging Asia

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Cardiovascular disease risk stratification and prognostication are very important for treatment planning. In addition, for a growing number of patients with overt symptomatic heart failure or asymptomatic but have structural heart disease, accurate risk stratification is essential. Conventional clinical cardiovascular risk factors, several biomarkers and echo-Doppler indexes are generally used to satisfy this need. However, non-invasive approaches to direct structural and tissue characterization of the myocardium have not produced satisfactory results. The recent development of the late gadolinium enhancement (LGE) imaging allows fibrosis or myocardial inflammation to be visualized. A growing body of evidence for LGEbased prognostication has been reported. However, not all patients with heart failure or at risk for it have been assessed with LGE. Moreover, the degree of diffuse fibrosis or inflammation cannot be easily quantified with LGE techniques. Recently, introduced T1 mapping-based quantification can provide the volume of extracellular space suggestive of the degree of diffuse tissue fibrosis or inflammation. Even without gadolinium contrast, native T1 values can provide quantitative information on myocardial tissue status. Here, we review current evidence for T1 mapping-based risk stratification and prognostication for various cardiac diseases that can lead to heart failure or lethal arrhythmic events.

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Prognostic Value of Delayed Enhancement Cardiac Magnetic Resonance Imaging in Mitral Valve Repair

Cited by 21 publications

References 26 publications

Prognostic Value of Late Gadolinium Enhancement in Postoperative Morbidity following Mitral Valve Surgery in Rheumatic Mitral Stenosis

Prognostic Value of Late Gadolinium Enhancement in Postoperative Morbidity following Mitral Valve Surgery in Rheumatic Mitral Stenosis

Computed tomography angiography for imaging results of neochordal mitral valve repair

The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

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