European Radiology

, Volume 29, Issue 3, pp 1546–1554 | Cite as

Cardiac magnetic resonance in patients with mitral valve prolapse: Focus on late gadolinium enhancement and T1 mapping

  • Silvia PradellaEmail author
  • Giulia Grazzini
  • Marta Brandani
  • Linda Calistri
  • Cosimo Nardi
  • Fabio Mori
  • Vittorio Miele
  • Stefano Colagrande



To evaluate the incidence of late-gadolinium-enhancement (LGE) in mitral valve prolapse (MVP) (in the absence of other heart/valvular diseases), and its association with the degree of mitral regurgitation (MR) and/or with complex ventricular arrhythmia (ComVA), and to analyse the role of T1 mapping in the evaluation of MVP patients.


We included all consecutive patients with MVP who underwent during 2015–2016 a comprehensive cardiac magnetic resonance (CMR) examination at 1.5 T. We evaluated the association of LGE with the MR fraction and the presence of ComVA. We compared myocardial T1-native and post-contrast times and extracellular volume (ECV)-values between MVP patients, both with and without LGE, and the control group.


Thirty-four patients with MVP were selected (56 ± 14 years old, 59% male). All patients had MR; LGE and ComVA were present in 15 (44%) and 11 (34%) patients, respectively. Significant associations of LGE with both MR severity and ComVA were not found (p=0.72 and 0.79, respectively). T1 mapping confirmed the presence of LGE in all cases. In one patient a thin signal alteration resulted in more evident T1 mapping than LGE. Patients with MVP had higher native T1-values, lower post-contrast T1-values and increased ECV-values compared with controls (p=0.01, 0.01 and 0.00, respectively).


Focal fibrosis with LGE was found in about half the MVP patients and it was independent of the degree of the valve dysfunction and the presence of ComVA. T1 mapping allows diffuse myocardial wall alterations to be identified, but no significant associations between the MR severity and ComVA and T1/ECV values were found.

Key Points

• MVP is a common valvulopathy affecting 2–3% of the general population.

• MVP has been associated with an increased risk of arrhythmic complications and sudden cardiac death.

• CMR is a non-invasive imaging method that provides a precise and more accurate assessment of patients with MVP.


Cine magnetic resonance imaging Prolapsed mitral valve Gadolinium T1 mapping 









American Heart Association


Cardiac magnetic resonance


Complex ventricular arrhythmias


Extracellular volume


Late gadolinium enhancement


Left ventricular


Modified Look-Locker inversion


Mitral regurgitation


Mitral valve prolapse


Picture Archiving and Communication System


Phase-sensitive inversion recovery


Right ventricular




Sudden cardiac death


Steady-state free processing


Stroke volume



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Prof. Stefano Colagrande.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Observational

• Performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Silvia Pradella
    • 1
    Email author
  • Giulia Grazzini
    • 2
  • Marta Brandani
    • 2
  • Linda Calistri
    • 2
  • Cosimo Nardi
    • 2
  • Fabio Mori
    • 3
  • Vittorio Miele
    • 1
  • Stefano Colagrande
    • 2
  1. 1.Department of RadiologyCareggi University HospitalFlorenceItaly
  2. 2.Department of Experimental and Clinical Biomedical SciencesUniversity of Florence – Careggi University HospitalFlorenceItaly
  3. 3.Department of CardiologyCareggi University HospitalFlorenceItaly

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