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December 7, 2021Journal of the American Heart AssociationOpen Access

Mitral Valve Prolapse Induces Regionalized Myocardial Fibrosis

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Why the study?

Imaging reports linked myocardial fibrosis with sudden cardiac death in MVP, and postrepair ventricular dysfunction supported a link between fibrosis and MVP.

Population

Surgical patients with MVP, Dzip1 S14R/+ MVP mice, and primary human cardiac fibroblasts

Design

Translational histopathologic, murine, computational, and in vitro study

Discussion

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Overview

Supports MVP-related regional LV fibrosis pre-dysfunction; hypothesis-generating for arrhythmic risk and targeted therapies.

Key Points

  • To determine the distribution and biomechanical mechanisms of left ventricular myocardial fibrosis associated with mitral valve prolapse.
  • Histopathologic analysis of left ventricular biopsies from peripapillary, inferobasal, and apical myocardium in surgical mitral valve prolapse patients and Dzip1 S14R/+ knock-in mice.
  • Investigation of tension-dependent cellular pathways via computational mechanical simulations and cyclic stretch testing of primary human cardiac fibroblasts in vitro.
  • Regionalized fibrosis accompanied by elevated infiltration of macrophages and myofibroblasts was observed in the peripapillary myocardium of patients and progressed over time in mice.
  • Computational modeling and in vitro cyclic stretch demonstrated that chordal tension directly activates primary cilia mechanosensing pathways and increases extracellular matrix protein production.

Cite This Study

A 2021 study studied this question.

synapsesocial.com/papers/6a953206ce3f9e00f3e3cb1fhttps://doi.org/10.1161/jaha.121.022332
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Histopathological insights into mitral valve prolapse-induced fibrosis2023 · 9 citations
  2. 2Collagen Fiber Maturity and Architecture in MVP-Associated Fibrosis Quantified by Digital Pathology2025
  3. 3Arrhythmic Mitral Valve Prolapse as a Regional Stretch-Induced Cardiomyopathy with Fibro-Inflammatory Signature: A Conceptual Review2026
  4. 4Left Ventricular Fibrosis and CMR Tissue Characterization of Papillary Muscles in Mitral Valve Prolapse Patients2023 · 2 citations
  5. 5Mitral Valve Prolapse Associated with Mitral Annular Disjunction: Diagnosis, Prognosis, and Arrhythmic Risk2026