Several studies suggest that mitral valve prolapse (MVP) can be related to sudden cardiac death, owing to sustained ventricular arrhythmias (VAs)1. In patients with sudden cardiac death and complex VAs, a high percentage of left ventricle (LV) inferolateral fibrosis has been described using cardiac magnetic resonance (CMR) with late gadolinium enhancement technique (LGE)2-3. However, LGE presents several technical limitations and requires contrast agent administration4. Thanks to T1 mapping (T1-map) and feature tracking (FT) techniques, CMR may identify myocardial fibrosis and deformation abnormalities respectively without contrast...

73 consecutive patients (age: 57 ± 13 y) with indication to mitral valve repair for severe mitral regurgitation due to mitral valve prolapse and 42 healthy subjects were prospectively enrolled. CMR FT analysis of steady state free precession (SSFP) short axis cine images was performed in each patients to obtain 2D global and segmental circumferential and radial strains. In addition, CMR including Modified Look-Locker (MOLLI) sequences for T1 mapping were acquired in 58 out of 73 patients (79%) in order to determine global and segmental...

Compared to controls, in MVP patients: 1) global average myocardial nT1 were significantly higher (p

Patients with MVP and severe mitral regurgitation present diffuse and focal fibrosis of the LV inferolateral are higher compared to controls associated with reduced circumferential and radial strains. Further studies are needed to evaluate if these changes are associated with higher risk for VA.

1Centro Cardiologico Monzino, IRCCS, Milan, Italy 2Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital, Policlinico of Bari 3 Department of Medicine, Institute of Radiology, University of Padova, Italy 4 Division of Cardiology, Department of Medicine, University of Verona 5 Department of Cardiology Univerity of Insubria Varese, Italy

1. Narayanan, K., et al., Mitral valve prolapse and sudden cardiac arrest in the community. Heart Rhytm, 2016. 13 (2): p. 498-503. 2.Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death. Circulation, 2015. 132(7): p. 556-66 3.Kitkungvan, D., et al., Myocardial Fibrosis in Patients With Primary Mitral Regurgitation With and Without Prolapse. Journal of the American College of Cardiology, 2018. 72(8): p. 823-834. 4.Muscogiuri, G., et al., Cardiac Magnetic Resonance T1-Mapping of the Myocardium: Technical Background and Clinical Relevance. J Thorac Imaging, 2018. 33(2): p. 71-80.