What does this research mean for the field?

Elevated late gadolinium enhancement (> 6% of LV mass) is an independent predictor of adverse events in patients with mitral valve prolapse. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research examines how certain factors can predict the occurrence of ventricular arrhythmias in patients with mitral valve prolapse.

February 8, 2026

Predictors of ventricular arrhythmia in patients with mitral valve prolapse - cardiac MRI study

Key Result

In MVP patients, elevated late gadolinium enhancement >6% of LV mass independently predicts ventricular arrhythmia-related events with OR 14.90 (P=0.02).

Key Points

This research examines how certain factors can predict the occurrence of ventricular arrhythmias in patients with mitral valve prolapse.
Evaluated consecutive patients with mitral valve prolapse using cardiac MRI scans.
Used Holter monitoring and exercise tests to record arrhythmias like PVCs and VT.
Analyzed LGE as a percentage of left ventricular mass, categorized into tertiles.
Measured mitral annular disjunction and identified papillary muscle fibrosis using LGE sequences.
47%, 46%, and 93% of patients in the 1st, 2nd, and 3rd LGE tertiles experienced the combined clinical endpoint (CEP).
Late gadolinium enhancement was found to be an independent predictor of CEP.
Higher levels of LGE (> 6% of LV mass) significantly increased the odds of the CEP.

Structured PICO

Does elevated late gadolinium enhancement on cardiac MRI predict ventricular arrhythmias in patients with mitral valve prolapse?

Population

45 consecutive patients with mitral valve prolapse (MVP), mean age 56 ± 16 years.

Intervention

Cardiac MRI assessment of Late Gadolinium Enhancement (LGE) > 6% of LV mass.

Comparator

Lower LGE tertiles (≤ 1% and 2-5% of LV mass).

Outcome

Combined clinical endpoint (CEP) defined as the presence of ventricular tachycardia (VT), multiform PVCs, ablation due to multiple PVCs, and new implantable cardioverter defibrillator insertion.composite

Elevated late gadolinium enhancement (>6% of LV mass) on cardiac MRI is a strong independent predictor of ventricular arrhythmias in patients with mitral valve prolapse.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Introduction The outcome of patients with mitral valve prolapse (MVP) largely depends on the presence of ventricular arrhythmias. Our aim was to evaluate the possible predictors of ventricular arrhythmias among the patients with MVP from cardiac MRI (CMR) study. Methods Consecutive patients (n = 45, mean age 56 ± 16 y) with MVP underwent a CMR scans. Premature ventricular beats (PVCS) and ventricular tachycardia (VT) were recorded by 24-hour Holter monitoring and exercise stress test. Late gadolinium enhancement (LGE) was calculated as percentage of left ventricular (LV) mass and was analyzed by tertiles – 1st tertile (≤ 1%), 2nd (2 – 5%) and 3rd tertile 6% of LV mass. Mitral annular disjunction (MAD) was measured in millimeters in a 3-chamber cine sequence. Papillary muscle fibrosis (PMF) was identified from LGE sequences. The combined clinical endpoint (CEP) was defined as the presence of VT, multiform PVC's, ablation due to multiple PVC's and new implantable cardioverter defibrillator insertion. Results The CEP was documented in 47%, 46% and 93% of the 1st, 2nd and 3rd LGE tertiles, respectively (p for trend = 0.01). A logistic regression analysis to predict CEP including age, gender, LV ejection fraction, mitral regurgitation severity, MAD, PMF and LGE demonstrating that LGE, but not other confounders was an independent predictor of CEP as a continuous variable (OR 1.83; 1.04 - 3.21, P = 0.03) or 3rd tertile ( 6%) (OR 14.90; 1.53 – 144.22, P = 0.02). Conclusion Elevated LGE ( 6% of LV mass) was found to be an independent predictor of the CEP in MVP patients. These results highlight the potential role of myocardial fibrosis in MVP arrhythmias.

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