Late gadolinium enhancement (RR 6.40), T-wave inversion (RR 1.60), and mitral annular disjunction (RR 1.77) were significantly associated with ventricular arrhythmias in mitral valve prolapse.
Meta-Analysis
Do specific clinical, electrocardiographic, and imaging markers predict ventricular arrhythmias in patients with mitral valve prolapse?
Easily obtained clinical, ECG, and imaging markers, particularly late gadolinium enhancement and mitral annular disjunction, can effectively stratify the risk of ventricular arrhythmias in patients with mitral valve prolapse.
Estimación del efecto: RR 6.40 (95% CI 2.11-19.39)
valor p: p=0.001
Mitral valve prolapse (MVP) has an estimated prevalence of 2-3% in the general population. Patients with MVP have an increased risk of ventricular arrhythmic events. The aim of this meta-analysis was to identify easily obtained markers that can be used for the arrhythmic risk stratification of MVP patients. This meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA Statement). The search strategy identified 23 studies that were finally included in the study. The quantitative synthesis showed that late gadolinium enhancement (LGE) RR 6.40 (2.11-19.39), I2 77%, P = 0.001, longer QTc interval mean difference: 14.2 (8.92-19.49) I2 0%, P < 0.001, T-wave inversion in inferior leads RR 1.60 (1.39-1.86), I2 0%, P < 0.001, mitral annular disjunction (MAD) RR 1.77 (1.29-2.44), I2 37%, P = 0.0005, lower left ventricular ejection fraction (LVEF) mean difference: -0.77 (-1.48, -0.07) I2 0%, P = 0.03, bileaflet MVP RR 1.32 (1.16-1.49), I2 0%, P < 0.001, increased anterior mean difference: 0.45 (0.28, 0.61), I2 0%, P < 0.001 and posterior mean difference: 0.39 (0.26, 0.52), I2 0%, P < 0.001 mitral leaflet thickness were significantly associated with ventricular arrhythmias in MVP patients. On the other hand, gender, QRS duration, anterior, and posterior mitral leaflet length were not associated with increased risk of arrhythmias. In conclusion, inferior T-wave inversions, QTc interval, LGE, LVEF, MAD, bileaflet MVP, anterior, and posterior mitral leaflet thickness are easily obtained markers that can be used for the risk stratification of patients with MVP. Prospective studies should be designed for the better stratification of this population.
Bazoukis et al. (Mon,) conducted a meta-analysis in Mitral valve prolapse (MVP). Clinical and imaging risk markers (e.g., LGE, QTc, MAD) was evaluated on Ventricular arrhythmias (RR 6.40, 95% CI 2.11-19.39, p=0.001). Late gadolinium enhancement (RR 6.40), T-wave inversion (RR 1.60), and mitral annular disjunction (RR 1.77) were significantly associated with ventricular arrhythmias in mitral valve prolapse.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: