2022/07 - Cardiovascular magnetic resonance characterization of rheumatic mitral stenosis: findings from three worldwide endemic zones [Journal Club]-Journal Club Webinar

Video Transcription

Video Summary

This JCMR Journal Club introduced a study on cardiovascular MRI characterization of rheumatic mitral stenosis across three endemic regions: India, China, and Mexico. The speakers described how rheumatic mitral stenosis leads to left atrial enlargement, pulmonary hypertension, right ventricular dilation/dysfunction, and sometimes unexpected left ventricular dysfunction. In 40 analyzed patients, CMR showed marked biatrial and biventricular remodeling compared with controls, including lower LV and RV ejection fractions, larger atria, and frequent right ventricular insertion-point late gadolinium enhancement (LGE). LGE was present in 82% of mitral stenosis patients versus 5% of controls, but there was no clear evidence of diffuse fibrosis on native T1 or ECV imaging. Country-level differences were noted, with some variation in LV function and atrial remodeling, possibly reflecting differences in disease progression or access to care. The discussion emphasized that RV involvement may be more important than previously appreciated and that future studies should examine post-intervention remodeling and outcomes. The session also covered practical issues in multicenter global CMR collaboration and reminded attendees about CME opportunities and upcoming Journal Club events.

Keywords

rheumatic mitral stenosis

cardiovascular MRI

left atrial enlargement

pulmonary hypertension

right ventricular dysfunction

late gadolinium enhancement

biatrial remodeling

biventricular remodeling

native T1 ECV