Imaging of Mitral Valve Area by Cardiac Magnetic Resonance in Patients with Rheumatic Mitral Stenosis

Background: Rheumatic heart disease which is a result of rheumatic fever is still a major health problem in developing countries. Rheumatic mitral stenosis (MS) is the commonest delayed valvular affection as a consequence of rheumatic fever. The assessment of MS severity by measuring mitral valve area (MVA) is very essential for patient management. Different imaging modalities are available for MVA assessment including echocardiography and cardiovascular magnetic resonance (CMR).Objectives: The aim of this study is to compare the planimetric MVA between CMR and two dimensional echocardiography in MS patients.Patients and methods: A forty adult patients with symptomatic mitral stenosis were included in the study. Other significant valvular lesions, atrial fibrillation, poor echocardiographic window, contraindications to CMR, and NYHA IV were excluded from the study. All patients were assessed by 2D echocardiography and CMR for MVA measurement.Results: the mean 2D TTE MVA was 1.2±0.26 cm2, while the mean CMR MVA 1.2±0.28 cm2. No significant statistical difference was found between both methods (P value 0.842) with a very strong correlation between both methods (r = 0.93 and p-value < 0.0001). The mean difference of MVA between the two methods was 0.012 cm2.Conclusion: CMR is a non-invasive imaging modality that provides MVA measurement and is a reliable method in the diagnosis of MS patients.