Moderate-severe mitral regurgitation was not significantly associated with ventricular arrhythmia burden or complexity in 72 patients with arrhythmic mitral valve prolapse.
Is moderate-severe mitral regurgitation associated with an increased burden of complex ventricular arrhythmias in patients with arrhythmic mitral valve prolapse?
In patients with arrhythmic mitral valve prolapse, the severity of mitral regurgitation is not significantly associated with the complexity or burden of ventricular arrhythmias, indicating that even patients with minimal MR remain at risk for arrhythmic complications.
Absolute Event Rate: 0% vs 0%
Abstract Background Though severe mitral regurgitation has often been considered a risk factor for ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD) in Arrhythmic Mitral Valve Prolapse (MVP), a majority of the sudden deaths (80%) actually occur in patients with less than severe MR. Purpose To assess whether moderate-severe MR is associated with complex ventricular arrhythmias (VAs) in a cohort of patients with Arrhythmic MVP. Methods A prospective, single-center cohort of 72 consecutive patients with MVP who underwent hybrid 18Flourodeoxyglucose positron emission tomography/Magnetic Resonance (18F-FDGPET/MR). VA categorization was performed according to the Lown and Wolf classification (grades 1, 2, 3, 4a and 4b) and the EHRA consensus statement severity criteria for Arrhythmic MVP. Patients were divided according to MR severity in 2 groups: 1) mild to moderate (grade 1/2) or 2) moderate to severe (grade 3/4). Results The groups did not significantly differ in baseline characteristics, metabolic activity or uptake pattern assessed by 18F-FDGPET/MR (Table). Arrhythmic burden and complexity were similar between groups (e.g. Lown and Wolf grade ≥3 with p = 0.648), although a small trend towards greater VAs of moderate severity (i.e. VT runs 120–179 bpm), as classified based on the EHRA severity criteria, was observed in the moderate-severe MR group (71.43 vs 30.77%, p=0.065). Conclusion In a cohort of patients with MVP, the degree of MR was not associated with arrhythmic burden, complexity, or with metabolic activity detected by 18F-FDGPET/MR. This adds further credence to the observation that even patients with minimal degrees of mitral regurgitation are at risk for arrhythmic complicationsTable
Ballesteros et al. (Sat,) reported a other. Moderate-severe mitral regurgitation was not significantly associated with ventricular arrhythmia burden or complexity in 72 patients with arrhythmic mitral valve prolapse.