Commentary: Scar! What is it Good For? Absolutely Nothing!

It is not a novel point that the mitral valve (MV) does not operate in isolation. Its form and function are affected by that of the rest of the left ventricle (LV) and vice versa. So it is reasonable to expect that an intervention on one of these will not universally correct defects in the other, and that intervening on both will not correct an irreversible problem. There is value in the ability to predict when intervention will fall short of correcting function or restoring form. Using gadolinium-enhanced (GE) MRI our colleagues in Kyoto examined whether total myocardial hyperenhancement, or if the number of myocardial segments with delayed enhancement, predicted LV reverse remodeling following MV repair (MVr) for ischemic mitral regurgitation (IMR).