Prevalence of Mitral Annular Disjunction at Cardiac MRI: Results from a Multicenter Registry

Purpose To determine the prevalence of mitral annular disjunction (MAD) in patients undergoing cardiac MRI for various clinical indications and to assess the association of MAD with arrhythmia, mitral valve prolapse (MVP), and myocardial alteration. Materials and Methods This study analyzed data from a retrospective observational registry of consecutive patients undergoing cardiac MRI for different clinical indications. Cardiac MRI examinations were performed from January 2019 to June 2019 at 13 Italian hospitals. Images underwent double reading by expert cardiac radiologists from the enrolling center and the core laboratory to assess the presence of MAD. Presence and maximum length of MAD and its association to MVP pattern, functional and structural myocardial alteration, and arrhythmia were evaluated using nonparametric and parametric tests. Logistic regression models were used to identify predictors of arrhythmia. Results Cardiac MRI studies from 2611 consecutive patients (1730, 66% male; median age, 53 years; IQR, 39-65 years) were evaluated. Prevalence of MAD was 5.44% (142 of 2611). MAD was an incidental finding in 74.6% (106 of 142) of patients. Patients with MAD had a higher prevalence of arrhythmias compared with patients without MAD (40% [57 of 142] vs 18% [444 of 2469]; <i>P</i> < .001). Patients with MAD and bileaflet MVP showed a longer MAD compared with patients with single-leaflet or absent MVP (median, 7 mm [IQR, 3-9.5 mm] vs 4 mm [IQR, 3-5 mm]; <i>P</i> < .001), a higher prevalence of systolic curling (75% [21 of 28] vs 30.7% [35 of 114]; <i>P</i> < .001), higher extracellular volume values (30% [IQR, 28%-32%] vs 27% [IQR, 25%-30%]; <i>P</i> = .04), and a higher prevalence of arrhythmia (64.2% [18 of 28] vs 34.2% [39 of 114]; <i>P</i> = .006). MAD length of at least 5 mm was an independent predictor of arrhythmia (odds ratio 3.96; 95% CI: 1.93, 8.15; <i>P</i> < .001). Conclusion MAD was a frequent incidental finding on cardiac MRI scans from a multicenter registry. MAD length of at least 5 mm and coexisting bileaflet MVP showed a higher risk of arrhythmia. <b>Keywords:</b> MR Imaging, Cardiac, Mitral Annular Disjunction <i>Supplemental material is available for this article.</i> ©RSNA, 2024.

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Journal
Radiology Cardiothoracic Imaging
Published
2024-12-01
DOI
https://doi.org/10.1148/ryct.230428
Citations
5
Primary Topic
Cardiac Valve Diseases and Treatments
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article
Field-Weighted Citation Impact
2.01
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article

Prevalence of Mitral Annular Disjunction at Cardiac MRI: Results from a Multicenter Registry

Riccardo Cau, Antonio Esposito, Silvia Pradella, Dario Plataroti et al.
5 citations
Radiology Cardiothoracic Imaging
Cardiac Valve Diseases and Treatments
2.01
article

Prevalence of Mitral Annular Disjunction at Cardiac MRI: Results from a Multicenter Registry

Riccardo Cau, Antonio Esposito, Silvia Pradella, Dario Plataroti, Paolo Rondi, Michele Porcu, Giulia Cundari, Alessandro Carriero, Pierpaolo Palumbo, Massimo Imbriaco, Nunzia Di Meo, Carmelo De Gori, Tommaso D’Angelo, Andrea Ponsiglione, Marco Ravanelli, Nicola Galea, Davide Tore, Giovanni Donato Aquaro, Giovanni Ferrandino, Simone Barbieri, Serena Dell’Aversana, Ernesto Di Cesare, Emanuele Neri, Riccardo Faletti, Luca Saba, Alfredo Blandino, Agnese Siani, Davide Vignale, Luigi Lovato, Elisa Bruno, Ludovica R. M. Lanzafame, Virginia Sambuceti, Davide Farina, Marco Gatti, Sara Seitun, Lorenzo Faggioni, Carlo Liguori, Anna Palmisano, Raffaele Ascione, Vittorio Miele, Livia Marchitelli, Alice S. Rossi, Margherita Adami, Michele Cosenza
article en
5 citations

Abstract

Purpose To determine the prevalence of mitral annular disjunction (MAD) in patients undergoing cardiac MRI for various clinical indications and to assess the association of MAD with arrhythmia, mitral valve prolapse (MVP), and myocardial alteration. Materials and Methods This study analyzed data from a retrospective observational registry of consecutive patients undergoing cardiac MRI for different clinical indications. Cardiac MRI examinations were performed from January 2019 to June 2019 at 13 Italian hospitals. Images underwent double reading by expert cardiac radiologists from the enrolling center and the core laboratory to assess the presence of MAD. Presence and maximum length of MAD and its association to MVP pattern, functional and structural myocardial alteration, and arrhythmia were evaluated using nonparametric and parametric tests. Logistic regression models were used to identify predictors of arrhythmia. Results Cardiac MRI studies from 2611 consecutive patients (1730, 66% male; median age, 53 years; IQR, 39-65 years) were evaluated. Prevalence of MAD was 5.44% (142 of 2611). MAD was an incidental finding in 74.6% (106 of 142) of patients. Patients with MAD had a higher prevalence of arrhythmias compared with patients without MAD (40% [57 of 142] vs 18% [444 of 2469]; <i>P</i> < .001). Patients with MAD and bileaflet MVP showed a longer MAD compared with patients with single-leaflet or absent MVP (median, 7 mm [IQR, 3-9.5 mm] vs 4 mm [IQR, 3-5 mm]; <i>P</i> < .001), a higher prevalence of systolic curling (75% [21 of 28] vs 30.7% [35 of 114]; <i>P</i> < .001), higher extracellular volume values (30% [IQR, 28%-32%] vs 27% [IQR, 25%-30%]; <i>P</i> = .04), and a higher prevalence of arrhythmia (64.2% [18 of 28] vs 34.2% [39 of 114]; <i>P</i> = .006). MAD length of at least 5 mm was an independent predictor of arrhythmia (odds ratio 3.96; 95% CI: 1.93, 8.15; <i>P</i> < .001). Conclusion MAD was a frequent incidental finding on cardiac MRI scans from a multicenter registry. MAD length of at least 5 mm and coexisting bileaflet MVP showed a higher risk of arrhythmia. <b>Keywords:</b> MR Imaging, Cardiac, Mitral Annular Disjunction <i>Supplemental material is available for this article.</i> ©RSNA, 2024.

Radiology Cardiothoracic ImagingVol. 6(6)
University of Pisa (IT), Vita-Salute San Raffaele University (IT)
Good health and well-being
Openalex Percentile: Top 11%
Cardiac Valve Diseases and Treatments
2.01
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