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Review
. 2021 Apr;14(4):867-878.
doi: 10.1016/j.jcmg.2020.10.027. Epub 2021 Feb 10.

Importance of Myocardial Fibrosis in Functional Mitral Regurgitation: From Outcomes to Decision-Making

Bernardo B C Lopes  1 , Deborah H Kwon  2 , Dipan J Shah  3 , John R Lesser  4 , Vinayak Bapat  4 , Maurice Enriquez-Sarano  4 , Paul Sorajja  4 , João L Cavalcante  5
Affiliations
Free article
Review

Importance of Myocardial Fibrosis in Functional Mitral Regurgitation: From Outcomes to Decision-Making

Bernardo B C Lopes et al. JACC Cardiovasc Imaging. 2021 Apr.
Free article

Abstract

Functional mitral regurgitation (FMR) is a common and complex valve disease, in which severity and risk stratification is still a conundrum. Although risk increases with FMR severity, it is modulated by subjacent left ventricular (LV) disease. The extent of LV remodeling and dysfunction is traditionally evaluated by echocardiography, but a growing body of evidence shows that myocardial fibrosis (MF) assessment by cardiac magnetic resonance (CMR) may complement risk stratification and inform treatment decisions. This review summarizes the current knowledge on the comprehensive evaluation that CMR can provide for patients with FMR, in particular for the assessment of MF and its potential impact in clinical decision-making.

Keywords: cardiac magnetic resonance; functional mitral regurgitation; myocardial fibrosis; secondary mitral regurgitation.

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Conflict of interest statement

Funding Support and Author Disclosures Dr. Bapat has received consulting fees from Medtronic, Edwards Lifesciences, Abbott Structural, Boston Scientific, and 4C. Dr. Sorajja has received consulting fees from Abbott Structural, Medtronic, Boston Scientific, Edwards Lifesciences Admedus, Gore, and Teleflex; has received research grant support from Abbott Structural, Medtronic, and Boston Scientific; and has been a speaker for Abbott Structural. Dr. Cavalcante has received consulting fees from Boston Scientific and Abbott Vascular; has received research grant support from Circle Cardiovascular Imaging, Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott Vascular; and has been a speaker for Medtronic, Circle Cardiovascular Imaging, and Siemens Healthineers. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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