A CMR-based Study of Torsional Behavior of Left Ventricle Post-Mitral Valve Repair Surgery

Cardiac function is intricately associated with the mechanical dynamics of the left ventricle (LV), particularly its torsional deformation. Mitral valve prolapse (MVP), a prevalent cardiac abnormality, often necessitates surgical repair (MVRe) or replacement (MVRp), which may impact LV torsion and overall cardiac kinematics. This study investigates the changes in LV torsion following MVRe by employing advanced cine cardiac magnetic resonance (CMR) imaging techniques combined with non-rigid image registration to capture and quantify complex three-dimensional myocardial deformations. A small cohort of MVP patients (N=3) was analyzed pre- and post-surgery using an approach that measures in-plane rotations and torsions. This assessment allowed for the characterization of LV torsion across different myocardial transmural depths. Our findings indicated notable alterations in the torsional mechanics post-surgery, particularly in the endocardial layer. These changes suggest that regional torsion, especially within the endocardium, may serve as a useful marker for evaluating the effects of surgical interventions in MVP patients, potentially informing preoperative surgical planning and postoperative care strategies.