Clinical Report: Strain Patterns in Mitral Valve Prolapse
Overview
The article describes a study designed to characterize global and regional myocardial strain in patients with mitral valve prolapse (MVP) using cardiac magnetic resonance feature tracking (CMR-FT), compared with controls without apparent heart disease. Its rationale is to clarify how MVP-associated basal mechanical features, including systolic curling and mitral annular disjunction, relate to strain patterns; the supplied material does not include the study’s results.
Background
MVP affects approximately 2–3% of the population and is often associated with a favorable prognosis, although significant mitral regurgitation and ventricular arrhythmias can occur. Echocardiographic studies have reported altered regional contraction despite preserved global ejection fraction, while prior CMR-FT investigations have produced inconsistent findings and often involved small cohorts or did not focus primarily on strain. CMR-FT can quantify global and regional strain using standard CMR sequences, and its strain measurements are not directly interchangeable with those from speckle-tracking echocardiography. The 2025 ESC/EACTS guideline context provided emphasizes comprehensive transthoracic echocardiographic assessment in MVP, including leaflet morphology, regurgitation, chamber function, and recognition of mitral annular disjunction.
Data Highlights
The supplied article material provides no cohort size, numerical strain results, or statistical comparisons. It states that the study aimed to assess global and regional longitudinal endocardial strain across left ventricular segments, as well as right ventricular and left atrial strain, in patients with MVP and controls.
Key Findings
The study was designed to compare CMR-FT strain patterns in a well-defined cohort of otherwise healthy patients with MVP and controls without apparent heart disease.
The planned assessment included global and regional longitudinal endocardial strain throughout the left ventricle, in addition to right ventricular and left atrial strain.
The study rationale specifically addressed whether MVP-related basal features, including systolic curling and mitral annular disjunction, are reflected in CMR-FT strain measurements.
Earlier CMR-FT studies cited in the article reported differing patterns: one found superior basal regional longitudinal and circumferential strain in MVP, while another reported mildly lower global longitudinal, circumferential, and radial strain in patients with moderate-to-severe mitral insufficiency.
A further 2023 CMR-FT investigation cited in the article reported reduced longitudinal strain, particularly in the inferior and inferolateral basal wall, and a slight reduction in global longitudinal strain in MVP compared with controls.
The article notes that CMR-FT and speckle-tracking echocardiography use distinct technical principles, so strain values from the two modalities cannot be directly compared.
Clinical Implications
The article frames CMR-FT as a means of characterizing regional myocardial mechanics in MVP and of interpreting basal strain abnormalities in the context of prolapse-related structural features. The supplied material does not report study results or establish a specific change in clinical management.
Conclusion
The study was intended to address limited and inconsistent evidence on CMR-derived strain patterns in MVP, with particular attention to basal mechanics and strain beyond the left ventricle. Its findings are not included in the provided source material.
by Jeffrey Ji-Peng Li, Shing Ching, Annette Aigner, Frank Edelmann, Stefanie Maria Werhahn, Rebecca Beyer, Jeanette Schulz-Menger, Jennifer Erley, Misael Estepa, Cyrill Meuwly, Ann-Sophie Eggers, Christian Stehning, Djawid Hashemi, Natalia Solowjowa, Christoph Klein, Ingo Hilgendorf, Sebastian Kelle, Patrick Doeblin
