In MVP patients, elevated late gadolinium enhancement >6% of LV mass independently predicts ventricular arrhythmia-related events with OR 14.90 (P=0.02).
Does elevated late gadolinium enhancement on cardiac MRI predict ventricular arrhythmias in patients with mitral valve prolapse?
Elevated late gadolinium enhancement (>6% of LV mass) on cardiac MRI is a strong independent predictor of ventricular arrhythmias in patients with mitral valve prolapse.
Absolute Event Rate: 0% vs 0%
Abstract Introduction The outcome of patients with mitral valve prolapse (MVP) largely depends on the presence of ventricular arrhythmias. Our aim was to evaluate the possible predictors of ventricular arrhythmias among the patients with MVP from cardiac MRI (CMR) study. Methods Consecutive patients (n = 45, mean age 56 ± 16 y) with MVP underwent a CMR scans. Premature ventricular beats (PVCS) and ventricular tachycardia (VT) were recorded by 24-hour Holter monitoring and exercise stress test. Late gadolinium enhancement (LGE) was calculated as percentage of left ventricular (LV) mass and was analyzed by tertiles – 1st tertile (≤ 1%), 2nd (2 – 5%) and 3rd tertile 6% of LV mass. Mitral annular disjunction (MAD) was measured in millimeters in a 3-chamber cine sequence. Papillary muscle fibrosis (PMF) was identified from LGE sequences. The combined clinical endpoint (CEP) was defined as the presence of VT, multiform PVC's, ablation due to multiple PVC's and new implantable cardioverter defibrillator insertion. Results The CEP was documented in 47%, 46% and 93% of the 1st, 2nd and 3rd LGE tertiles, respectively (p for trend = 0.01). A logistic regression analysis to predict CEP including age, gender, LV ejection fraction, mitral regurgitation severity, MAD, PMF and LGE demonstrating that LGE, but not other confounders was an independent predictor of CEP as a continuous variable (OR 1.83; 1.04 - 3.21, P = 0.03) or 3rd tertile ( 6%) (OR 14.90; 1.53 – 144.22, P = 0.02). Conclusion Elevated LGE ( 6% of LV mass) was found to be an independent predictor of the CEP in MVP patients. These results highlight the potential role of myocardial fibrosis in MVP arrhythmias.
Brodov et al. (Sat,) reported a other. In MVP patients, elevated late gadolinium enhancement >6% of LV mass independently predicts ventricular arrhythmia-related events with OR 14.90 (P=0.02).