Valvular Cardiomyopathy: The Value of Cardiovascular Magnetic Resonance Imaging

Cardiovascular magnetic resonance (CMR) imaging has had a vast impact on the understanding of a wide range of disease processes and pathophysiological mechanisms. More recently, it has contributed significantly to the diagnosis and risk stratification of patients with valvular heart disease. With its increasing use, CMR allows for a detailed, reproducible, qualitative, and quantitative evaluation of left ventricular volumes and mass, thereby enabling assessment of the haemodynamic impact of a valvular lesion upon the myocardium. Postprocessing of the routinely acquired images with feature tracking CMR methodology can give invaluable information about myocardial deformation and strain parameters that suggest subclinical ventricular impairment that remains undetected by conventional measures such as the ejection fraction (EF). T1 mapping and late gadolinium enhancement (LGE) imaging provide deep myocardial tissue characterisation that is changing the approach towards risk stratification of patients as an increasing body of evidence suggests that the presence of fibrosis is related to adverse events and prognosis. This review summarises the current evidence regarding the utility of CMR in the left ventricular assessment of patients with aortic stenosis or mitral regurgitation and its value in diagnosis, risk stratification, and management.

Automated summary

Cardiovascular magnetic resonance (CMR) imaging has had a significant impact on understanding disease processes and mechanisms. It has played a crucial role in the diagnosis and risk stratification of valvular heart disease patients. CMR allows for detailed evaluation of left ventricular volumes and mass, providing insights into the hemodynamic impact of valvular lesions on the myocardium. Additionally, CMR techniques such as feature tracking, T1 mapping, and late gadolinium enhancement (LGE) imaging offer valuable information on myocardial deformation, strain parameters, and tissue characterization, aiding in risk assessment and management of patients.