Key result
Pediatric MVP is linked to widened frontal QRS-T angle by ~9 degrees versus controls.
Why the study?
The occurrence of symptoms in patients with mitral valve prolapse is linked to autonomic dysfunction and neuroendocrine causes rather than progressive mitral valve insufficiency, necessitating assessment of autonomic dysfunction and arrhythmia risk in these patients.
Do children with primary mitral valve prolapse exhibit increased ECG markers of autonomic dysfunction and arrhythmia risk compared to healthy controls?
Case-Control (n=127)
No
Do children with primary mitral valve prolapse exhibit increased ECG markers of autonomic dysfunction and arrhythmia risk compared to healthy controls?
Absolute Event Rate: 39.97% vs 31.23%
p-value: p=0.038
Children with primary mitral valve prolapse demonstrate altered ventricular repolarization markers such as increased frontal QRS-T angle and Tp-e interval, suggesting a potential increased risk for arrhythmias.
May signal arrhythmia vulnerability in pediatric MVP; hypothesis-generating and should not yet change practice.
Objective: The occurrence of symptoms in patients with mitral valve prolapse (MVP) is linked to autonomic dysfunction and neuroendocrine causes rather than progressive mitral valve insufficiency. The goal was to assess the risk of autonomic dysfunction and arrhythmia in patients with MVP.Methods: The study included 63 patients with primary MVP and a control group of 64 children of similar age and gender. Following a physical examination, all patients' histories were taken, and 12-lead ECGs, autonomic function tests, echocardiography, and 24-hour Holter rhythm studies were performed.Results: The patient group had a higher mean resting heart rate than the control group. Orthostatic hypotension was found in 8 patients (12.6%) and 4 children (6.2%) in the control group. When compared to the control group, patients with MVP had higher QTc dispersion, frontal QRS-T angle, Tp-e interval, and Tp-e/QTc ratio. There was no significant difference between the two groups in terms of conventional measurements of heart rate variability in the Holter ECG, as well as no significant difference in HRDC.Conclusion: Although cases with pathological findings in the initial ECG were excluded from our study, we believe that the high frontal QRS-T angle observed in MVP patients is a novel and significant finding. Furthermore, it has been discovered that HRDC, a new and understudied parameter in children, does not show a significant difference in patients with MVP.
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BİNDAL et al. (2023) conducted a case-control in Mitral Valve Prolapse (n=127). Mitral valve prolapse vs. Healthy age- and gender-matched children was evaluated on Frontal QRS-T angle (degrees) (p=0.038). Children with mitral valve prolapse exhibited a significantly widened resting frontal QRS-T angle (39.97 vs 31.23 degrees, p=0.038) and increased Tp-e interval compared to healthy controls.
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