Does the association between mitral annular disjunction (MAD) severity and arrhythmic risk in mitral valve prolapse differ by sex?
Risk stratification for arrhythmic events in MVP should consider sex-specific imaging parameters, with MAD length being more prognostic in men and bileaflet involvement potentially more relevant in women.
In a large MVP cohort, men exhibit greater MAD length and a stronger association between iMAD length and arrhythmic events. In contrast, iMAD length in women may be less important for arrhythmic risk stratification compared to other imaging parameters such as bileaflet involvement. Further studies are needed to confirm alternative mechanisms beyond localized MAD-related myocardial traction in women with MVP.
Cristin et al. (Tue,) studied this question.