{
  "abstract": "Purpose Echocardiography and cardiac magnetic resonance(CMR) are the reference standards for diagnosing mitral valve prolapse (MVP) and mitral annular disjunction(MAD). Cardiac CT angiography (CTCA) may enable assessment of secondary MVP/MAD morphological features. We evaluated performance of CT-derived morphological parameters in patients with MV-disease.Materials and Method This retrospective multicenter study included 65patients:32 with CMR-confirmed MVP/MAD who also underwent a CTCA;33 controls. Six diastolic parameters were measured on CT and CMR: anterior and posterior MV-leaflet length(ALL; PLL)and thickness(ALT; PLT), anterolateral and posteromedial papillary muscles thickness(AL/PM-PMT). Group differences were assessed using the Mann-Whitney U test with false discovery rate correction; effect sizes were calculated. Spearman was used for correlations. Logistic regression and ROC analyses were performed. Agreement between CT and CMR was assessed using the Wilcoxon test and Bland–Altman (figures 1 and 2).Results MVP/MAD patients showed higher CT-leaflet thickness and length compared with controls(adjusted p ≤ 3.83×10 −11),with large effect sizes(0.75–0.86).CT-PMT showed significance difference(PM-PMT p=0,019;AL-PMT P=0,05),although weaker, with smaller effect(0.30–0.23).At logistic regression, CT-PLT(p = 0.0047), CT-ALL and CT-PLL(p < 0.001),and CT-PMT(PM-PMT p = 0.006 and AL-PMT p = 0.04)were significant predictors. CT-ALT was not suitable for reliable regression estimation as showed near-complete separation. ROC analysis demonstrated excellent performance for leaflet parameters: AUC=0.998(ALT),0.988(PLT), 0.93–0.96(leaflet length). CT-PMT showed lower discrimination (AUC 0.63–0.67). CT and CMR leaflet parameters showed strong correlation (ρ = 0.75–0.86, p < 0.001), with no significant differences at Bland-Altman (figure 3, table 1).Conclusion CTCA can reliably assess secondary morphological features of MVP/MAD, particularly leaflet length and thickness, that demonstrate near-perfect diagnostic performance. In patients undergoing CT coronary angiography, which CT-derived morphological parameter is most accurate for identifying patients with mitral valve disease (MVP/MAD)?OptionsA. Papillary muscle thickness (PMT)B. Posterior leaflet length (PLL)C. Leaflet thickness (ALT/PLT)D. Mitral annular disjunction distanceAbstract 33 Figure 3Abstract 33 Table 1Diagnostic performance of CT-derived parametersAbstract 33 Figure 2Abstract 33 Figure 1E.Anterolateral papillary muscle thickness (AL-PMT)",
  "authors": [
    {
      "affiliations": [
        "Department of Medical Surgical Sciences and Translational Medicine Radiology Unit, Sant’Andrea Hospital ,Sapienza University of Rome, Rome, IT",
        "Department of Radiology, Guys and St Thomas’ NHS Foundation Trust London, UK"
      ],
      "name": "Federica Fanelli"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London, UK"
      ],
      "name": "Caterina Guerra"
    },
    {
      "affiliations": [
        "Department of Radiology, Guys and St Thomas’ NHS Foundation Trust London, UK"
      ],
      "name": "Michelle Mak"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London, UK"
      ],
      "name": "Piergiorgio Masci"
    },
    {
      "affiliations": [
        "Department of Medical Surgical Sciences and Translational Medicine Radiology Unit, Sant’Andrea Hospital ,Sapienza University of Rome, Rome, IT"
      ],
      "name": "Marco Francone"
    },
    {
      "affiliations": [
        "Department of Radiology, Guys and St Thomas’ NHS Foundation Trust London, UK",
        "Department of Cardiovascular Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London, UK"
      ],
      "name": "Giulia Benedetti"
    }
  ],
  "title": "33 CT-derived morphological markers of mitral valve prolapse and mitral annular disjunction: a multicenter imaging study",
  "uid": "3dff38a4-3094-5141-b667-e41856c5d87d"
}