Abstract 16682: Abnormal Left Ventricular Deformation in Mitral Valve Prolapse

Abstract

Background: Mitral valve (MV) prolapse (MVP) is usually considered a primary valvular abnormality. We hypothesized that there are concomitant abnormalities in regional left ventricular (LV) function in this syndrome. Objective: To characterize LV global and regional strain in MVP with and without significant mitral regurgitation (MR), defined as regurgitant fraction >15%, in comparison with controls using cardiac magnetic resonance (CMR). Methods: A total of 109 MVP patients (median age 51 years, 40% males) with normal LV ejection fraction, and a control group of 45 patients (47 years, 53% males) without structural heart disease by CMR were retrospectively included. From standard cine images we quantified LV volumes and ejection fraction and, using feature tracking, global and segmental longitudinal and circumferential peak systolic strains. Results: Significant MR was found in 49 (44%) of MVP patients. Compared with controls, MVP patients had significantly higher LV end-diastolic and end-systolic volumes without differences in ejection fraction (Table). While there were no differences in global strains, regional longitudinal and circumferential peak systolic strains were increased in the basal anterior and anterolateral segments, and reduced in the mid inferior segment (Table). When comparing only patients without significant MR with controls, these differences remained significant (Table). Conclusions: In patients with MVP and normal LV ejection fraction there is LV dilatation and increased basal anterior and anterolateral deformation in comparison with controls, even in the absence of significant MR. These findings suggest that MVP may be a disease not only of the MV but also of the adjacent myocardium.