Key result
Arrhythmic MVP linked to ~14-fold higher syncope rates, larger LVESV, and wider mitral annular disjunction.
Why the study?
The mechanism linking chronic mitral valve prolapse to serious ventricular arrhythmias and sudden cardiac death is not fully understood, especially without significant mitral regurgitation.
Do specific clinical and echocardiographic criteria predict the occurrence of complex ventricular arrhythmias in patients with mitral valve prolapse?
Observational (n=30)
Do specific clinical and echocardiographic criteria predict the occurrence of complex ventricular arrhythmias in patients with mitral valve prolapse?
Absolute Event Rate: 57% vs 4%
p-value: p=0.006
Increased left ventricular end-systolic volume and wider mitral annular disjunction on echocardiography are associated with a higher risk of complex ventricular arrhythmias in patients with mitral valve prolapse.
Hypothesis-generating for echocardiographic risk markers in mitral valve prolapse; leaves open prospective validation before clinical adoption.
Background: Chronic Mitral valve prolapse (MVP) has been linked to the occurrence of serious ventricular arrhythmias and sudden cardiac death. However, their mechanism is not fully understood particularly in the absence of haemodynamically significant mitral regurgitation (MR).Objectives: The aim of the study is to identify if there are specific clinical and echocardiographic criteria that can predict the occurrence of ventricular arrhythmias in patients with mitral valve prolapse.Methods:We prospectively enrolled 30 consecutive patients with MVP. Clinical examination, echocardiography (standard and speckle tracking) and 24 hours Holter monitoring were performed in all patients. The patients were further divided into 2 groups: arrhythmic MVP (7 patients) and non- arrhythmic MVP (23 patients) based on the presence of complex ventricular arrhythmias on Holter monitoring.Results: Patients with arrhythmic MVP experienced syncope more frequently compared to the non- arrhythmia group (57 vs 4%, p=0.006). They also had larger left ventricular (LV) end systolic volume (45 ± 8.8 vs 36 ± 8 ml, p=0.023) despite similar LV ejection fraction (EF) and global longitudinal strain (GLS). The arrhythmic MVP patients had wider mitral annular disjunction (7.7 ± 3.8 vs 3.9 ± 3.9 mm, p=0.033).There were no significant difference between the 2 groups regarding the degree of mitral regurgitation, leaflet affection (single or bileaflet) or mitral annular diameters.Conclusion:Increased left ventricular end systolic volume and the degree of annular disjunction by echocardiography may contribute to the arrhythmic risk in patients with MVP irrespective of the presence and severity of mitral regurgitation.
No takes yet. Share an insight, caveat, or question.
A 2020 study conducted an observational in Mitral valve prolapse (n=30). Arrhythmic mitral valve prolapse vs. Non-arrhythmic mitral valve prolapse was evaluated on Syncope (p=0.006). Arrhythmic mitral valve prolapse was associated with more frequent syncope (57% vs 4%, p=0.006), larger left ventricular end-systolic volume, and wider mitral annular disjunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: