Magnetic resonance imaging identifies significant LV mass reduction and improvement of LV enddiastolic volume index within 6 months follow-up in patients undergoing mitral valve repair

Objectives: Magnetic Resonance Imaging (MRI) has been shown to be a non-invasive highly sensitive diagnostic tool to identifiy changes in LV mass and volume. We therefore investigated the effects of mitral valve repair on LV function parameters including ejection fraction (EF; %), indices of LV mass (LVMI; g/m2) and volume (LVEDVI, LVESVI; ml/m2) as detected by MRI.

Material and Methods: 8 consecutive patients (mean age 53 (range 41–68) years) with severe mitral valve regurgitation (MVR; grade III-IV), normal LV function and sinus rhythm were included in this prospective study. MRI was performed pre-operative, as well as 6 months post-op, to identify changes in indices in LV mass and volume. In addition, ejection fraction, LA-diameter (mm), as well as cardiovascular accidents and death were analyzed. Data are given as mean±SEM.

Results: Post-op MVR was grade 0-I in all patients. Early and 6 months mortality was 0%. EF did not significantly change within the follow-up period (pre-op: 62±2 vs. post-op: 60±3, p=.35). A significant improvement of indices of LV mass and volume was detected by MRI within 6 months following surgery (LVMI: pre-op: 76±7 vs. post-op: 65±5, p=.006; LVEDVI: pre-op: 119±10 vs. post-op: 75±6, p=.005; LVESVI: pre-op: 44±4 vs. post-op: 33±4, p=.0001).

Conclusions: In this prospective study MRI was useful to identify a significant improvement of cardiac function parameters in patients undergoing mitral valve repair. We propose that MRI studies are useful diagnostics in cardiac patients where observer independence is of importance.