"Valvular Heart Disease" - Case-Based Webinar (CME)-Valvular Heart Disease

Video Transcription

Video Summary

The webinar introduced the SCMR’s second educational session, created in response to growing interest in cardiac MRI (CMR) for valvular heart disease. The speakers reviewed how CMR can supplement echocardiography by clarifying valve mechanism, quantifying regurgitation, assessing chamber remodeling, and detecting myocardial scar or fibrosis.<br /><br />Dr. Dipin Shah focused on primary mitral regurgitation (MR). He emphasized careful cine imaging across the entire mitral valve, accurate LV volume tracing, and phase-contrast flow measurements to calculate MR volume and fraction. He highlighted common pitfalls such as basal slice selection, papillary muscle handling, and annular descent during systole. He also showed how CMR can reveal important consequences of MR, including LV/LA dilation and late gadolinium enhancement (LGE) scar, especially in mitral valve prolapse or secondary MR due to infarction.<br /><br />Dr. Joao Cavalcante discussed secondary MR, emphasizing that it is primarily a ventricular disease. He reviewed evidence showing that MR severity alone does not fully explain outcomes; scar burden and ventricular remodeling strongly influence prognosis and response to therapies such as MitraClip. He also covered CMR’s role in aortic stenosis and aortic regurgitation, including valve planimetry, flow quantification, and the prognostic value of LGE and T1/ECV mapping for fibrosis. He highlighted the overlap of aortic stenosis with cardiac amyloidosis and suggested CMR can help identify patients who may still benefit from TAVR.<br /><br />The session concluded with practical advice on acquisition, contouring, mixed valve disease quantification, and the importance of standardized, reproducible CMR methods.

Keywords

cardiac MRI

CMR

valvular heart disease

mitral regurgitation

secondary MR

aortic stenosis

aortic regurgitation

echocardiography

late gadolinium enhancement

fibrosis

TAVR