Inferolateral T wave abnormalities occurred in 53% of MVP patients and were independent of ventricular arrhythmia burden, fibrosis, or increased metabolic activity.
Are inferolateral T wave abnormalities associated with complex ventricular arrhythmias, localized metabolic activity, and fibrosis in patients with arrhythmic mitral valve prolapse?
In patients with arrhythmic mitral valve prolapse, inferolateral T wave abnormalities do not correlate with localized fibrosis, increased metabolic activity, or ventricular arrhythmia burden, suggesting they reflect global rather than localized myocardial alterations.
Absolute Event Rate: 0% vs 0%
Abstract Background Repolarization abnormalities have been described in patients with mitral valve prolapse (MVP). Whether their presence or extension represents anatomical substrate for ventricular arrhythmias (VAs) and sudden cardiac death (SCD) remains a matter of debate. To our knowledge, the correlation of ECG repolarization changes and metabolic activity/fibrosis, using hybrid 18Flourodeoxyglucose positron emission tomography/Magnetic Resonance (18F-FDGPET/MR), has not been studied. Purpose To assess whether inferolateral T wave abnormalities are associated with complex VAs, localized metabolic activity and fibrosis in a cohort of patients with Arrhythmic MVP. Methods A prospective study of 72 consecutive patients with MVP who underwent hybrid 18F-FDGPET/MR. VA categorization was performed according to the Lown and Wolf classification and the EHRS consensus statement for diagnosis and severity criteria. Patients were divided into 2 groups according to the presence or absence of inferolateral T wave abnormalities (i.e. flat and/or negative T waves). Results As shown in the Table, no significant differences were found in metabolic activity in the basal and inferolateral midventricular segments (p=0.310) between groups. Furthermore, neither LGE nor PET-LGE colocalization showed any significant association with the ECG abnormalities. No differences were found on VA burden or complexity among both groups. Contrary to what has been previously suggested, these results suggest that inferolateral T wave abnormalities (present in 53% of the cohort) reflect a "global" myocardial alteration rather than localized inferolateral fibrosis and/or increased metabolic activity. The lack of metabolic activity and colocalization assessment by hybrid 18F-FDGPET/MR in previous studies might account for the differences observed. Conclusion In a prospective cohort of patients with MVP, inferolateral negative T wave abnormalities were independent of VA burden as well as fibrosis or increased inferoposterior metabolic activity.Table
Ballesteros et al. (Sat,) reported a other. Inferolateral T wave abnormalities occurred in 53% of MVP patients and were independent of ventricular arrhythmia burden, fibrosis, or increased metabolic activity.