Contemporary imaging of normal mitral valve anatomy and function.

PURPOSE OF REVIEW: Mitral valve disease is highly prevalent. Accurate characterization of normal anatomy and function of the mitral valve is crucial to understand the pathophysiology of mitral valve disease. This review summarizes recent advances in noninvasive cardiac imaging to assess normal mitral valve anatomy and function and provides an overview of the clinical applications of these novel imaging techniques in the evaluation of patients with mitral valve disease.

RECENT FINDINGS: Echocardiography remains the first imaging technique for evaluation of the anatomy and function of the mitral valve. However, advances in minimally invasive and transcatheter valve repair/replacement procedures demand high spatial resolution images to accurately assess the anatomy of the mitral valve and its surrounding structures. Three-dimensional echocardiography improves two-dimensional echocardiography morphological and functional mitral valve evaluation. Furthermore, computed tomography provides high spatial resolution three-dimensional data and may constitute the modality of choice for additional morphological or geometrical study of the mitral valve and surrounding structures. In addition, cardiac magnetic resonance permits accurate assessment of anatomy and function of the mitral valve and is considered the method of reference to quantify mitral flow.

SUMMARY: Any abnormality in any of the components of the mitral valve (annulus, leaflets, subvalvular apparatus, left ventricle and left atrium) may lead to mitral valve dysfunction. Current noninvasive cardiac imaging modalities permit accurate assessment of mitral valve anatomy and function. These imaging techniques refine our diagnostic performance, provide additional (patho)physiological insights and help to design new strategies for interventional or surgical treatment of the diseased mitral valve.