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A myriad of explanations underpin the mechanisms proposed for the LV annular dilatation following a myocardial infarction that eventually lead to mitral regurgitation. Most believe an active process drives remodeling of adjacent myocardium with subsequent secondary mitral annular dilation. However, non-geometric, passive mechanisms have not been considered as potential contributers to either the mitral valve or the annular patholgy. Classic CMR delayed hyperenhancement (DHE) describes a myriad of LV myocardial histopathology but may also be sensitive to non-myocardial pathology such as the annulus or the mitral leaflets.

2044 Can delayed hyperenhancement shed insight into the mechanism of mitral regurgitation?