Importance of Myocardial Fibrosis in Functional Mitral Regurgitation: From Outcomes to Decision-Making

Bernardo B.C. Lopes, Deborah H. Kwon, Dipan J. Shah, John R. Lesser, Vinayak Bapat, Maurice Enriquez-Sarano, Paul Sorajja, João L. Cavalcante

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


Functional mitral regurgitation (FMR) is a common and complex valve disease, in which severity and risk stratification is still a conundrum. Although risk increases with FMR severity, it is modulated by subjacent left ventricular (LV) disease. The extent of LV remodeling and dysfunction is traditionally evaluated by echocardiography, but a growing body of evidence shows that myocardial fibrosis (MF) assessment by cardiac magnetic resonance (CMR) may complement risk stratification and inform treatment decisions. This review summarizes the current knowledge on the comprehensive evaluation that CMR can provide for patients with FMR, in particular for the assessment of MF and its potential impact in clinical decision-making.

Original languageEnglish (US)
Pages (from-to)867-878
Number of pages12
JournalJACC: Cardiovascular Imaging
Issue number4
StatePublished - Apr 2021


  • cardiac magnetic resonance
  • functional mitral regurgitation
  • myocardial fibrosis
  • secondary mitral regurgitation
  • Mitral Valve Insufficiency/diagnostic imaging
  • Predictive Value of Tests
  • Ventricular Remodeling
  • Humans
  • Fibrosis
  • Cardiomyopathies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging


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