Key result
Cardiac magnetic resonance identifies myocardial fibrosis in malignant mitral valve prolapse affecting ~3% of patients.
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Why the study?
Mitral valve prolapse has distinct anatomical subtypes and variable clinical outcomes, with emerging recognition of malignant forms linked to arrhythmias and sudden cardiac death.
This comprehensive review highlights advancements in the understanding of mitral valve prolapse, particularly emphasizing the role of cardiac magnetic resonance imaging and phenotypic features like mitral annular disjunction in risk-stratifying patients for malignant arrhythmias.
Mitral valve prolapse (MVP) is a prevalent valvular abnormality affecting 2-3% of the general population. MVP has two distinct anatomical subtypes: Barlow's disease and fibroelastic deficiency; each reflects different underlying structural and pathological processes. While most individuals generally remain asymptomatic with subclinical regurgitation, some develop significant mitral regurgitation followed by heart failure. A malignant form of MVP, marked by bileaflet prolapse, mitral annular disjunction (MAD), and myocardial fibrosis, is increasingly recognized as a substrate for ventricular arrhythmias and sudden cardiac death. In addition to transthoracic/transesophageal echocardiography, cardiac magnetic resonance is expected to contribute to risk stratification, particularly in identifying high-risk features such as MAD and fibrosis. As diagnostic capabilities continue to advance, integrating phenotypic, imaging, and electrophysiological insights will be key to optimizing outcomes in patients with MVP. This review provides a comprehensive overview of MVP, encompassing its epidemiology, molecular mechanisms, imaging evaluation, and current therapeutic strategies.
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Yamaguchi et al. (2026) conducted a review in Mitral valve prolapse. Mitral valve prolapse affects 2-3% of the population, with malignant forms requiring imaging like cardiac magnetic resonance to identify high-risk features such as myocardial fibrosis.
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