4D Mitral Valve Motion Analysis Using Multi-Plane Cine Cardiac MRI Reconstructions for Functional Classification of Patients With Mitral Regurgitation

Mitral regurgitation (MR) is a common consequence of ventricular remodeling in heart failure (HF) patients with systolic dysfunction and is associated with diminished survival rates. Characterization of patient-specific anatomy and function of the regurgitant mitral valve (MV) can enhance surgical decision making in terms of medical device choice and deployment strategy for minimally invasive endovascular approaches for MV repair. As a first step toward pre-operative planning for MV repair, we examine the feasibility of using cardiac magnetic resonance (CMR) images acquired in multiple orientations to resolve leaflet function and timing. In this study, MV motion of a HF patient with ischemic heart disease exhibiting both adverse ventricular remodeling and MR was compared pre-operatively against a normal control from the Sunnybrook cardiac database, starting with manually segmented 2D MV contours from cine CMR images acquired in multiple orientations. We find that MV motion analysis from CMR imaging is feasible and anatomical reconstruction using oriented segmentations from a combination of imaging slices acquired in multiple orientations can help overcome inherent limitations of CMR image data in terms of resolving small anatomical features, owing to finite slice-thicknesses and partial volume effects.Copyright © 2014 by ASME