Can magnetic resonance imaging identify leaky heart valves that require surgery?

A prospective observational study examining the role of myocardial fibrosis in outcome following mitral valve repair In degenerative mitral regurgitation

People who have a severely leaking mitral valve – the heart valve between the left atrium and left ventricle - may not experience any symptoms for a long time, despite the fact that the main pumping chamber of the heart, the left ventricle, is under strain. Eventually, the left ventricle can become permanently damaged by this strain. Patients need surgery to repair the valve, ideally before heart damage has progressed to a severe stage. Surgeons have the option of operating when a person is well but this exposes the individual to the risks of major surgery and many people won’t need an operation for several years. Doctors rely on ultrasound to monitor a person’s heart but it is not completely accurate, so we need better ways to predict which patients will benefit from surgery and when it should be best carried out. Dr Richard Steeds and his team at the University of Birmingham have found that heart muscle scarring is present in patients with a leaky mitral valve and that people with scarring may benefit from early surgery. The BHF has awarded a grant to Dr Steeds to find out if magnetic resonance imaging (MRI) can detect this scarring, and if scarring affects the outcome of surgery. They will also confirm that the changes seen on MRI are due to scarring by examining tissue samples under the microscope after surgery. This research may reveal a safe, non-invasive method that could help doctors predict whether, and when, patients should be operated on.