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February 8, 2026European Heart Journal

Basal inferolateral LV hypertrophy is linked to higher event risk in Marfan patients independent of MVP.

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Why the study?

Localised hypertrophy of the inferolateral basal wall of the LV was noted in women with Marfan syndrome and MVP, prompting investigation into its prevalence, relationship with MVP and MAD, and prognostic value.

Does the presence of basal inferolateral hypertrophy (BILH) predict adverse clinical events in patients with Marfan syndrome?

Population

241 consecutive MFS patients aged >14 years with a pathogenic FBN1 variant and no prior thoracic surgery

Comparison

Presence vs absence of basal inferolateral hypertrophy

Design

Prospective single-centre cohort study

Follow-up

More than 6 years

Key result

Basal inferolateral LV hypertrophy occurred in 7.9% of Marfan patients, mainly women, and was linked to higher clinical events risk over 6 years independent of MVP or MAD.

Authors

OMO MilleronCDC DelhommeALA Lasne

Discussion

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Overview

May warrant closer monitoring in Marfan patients; hypothesis-generating and requires prospective validation.

Key Points

  • The study aims to describe basal inferolateral hypertrophy in women with Marfan syndrome and assess its relationship with mitral valve conditions and prognosis.
  • Conducted a prospective cohort study with patients having pathogenic FBN1 variant.
  • Analyzed echocardiographic measurements of left ventricular basals segments.
  • Defined BILH based on specific thickness measurements and ratios.
  • Followed patients for clinical outcomes over more than 6 years.
  • BILH was observed in 7.9% of 241 patients, significantly more in women.
  • MVP occurred in 38.1% and MAD in 21.5% of patients.
  • BILH was found 4.6 times more frequent in bivalvular MVP and 3.1 times more frequent with MAD.
  • BILH was associated with longer QTc intervals and subsequent clinical events in women.

Structured PICO

Does the presence of basal inferolateral hypertrophy (BILH) predict adverse clinical events in patients with Marfan syndrome?

P
Population
241 consecutive patients with a pathogenic variant of FBN1 (Marfan syndrome), aged >14 years, without previous thoracic surgery.
I
Intervention
Presence of basal inferolateral hypertrophy (BILH), defined as inferolateral basal segment thickness ≥12mm and a basal to mid segment wall thickness ratio ≥1.5 on transthoracic echocardiography.
C
Comparator
Absence of basal inferolateral hypertrophy (BILH).
O
Outcome
Composite of clinical events: aortic events, mitral valve surgery, symptomatic ventricular tachycardia or ICD implantation, and cardiovascular death.composite

Localized basal inferolateral left ventricular hypertrophy is a frequent echocardiographic finding in women with Marfan syndrome and mitral valve prolapse, and it is associated with a higher risk of adverse clinical events.

Cite This Study

Milleron et al. (2025) studied this question. Basal inferolateral LV hypertrophy occurred in 7.9% of Marfan patients, mainly women, and was linked to higher clinical events risk over 6 years independent of MVP or MAD.

synapsesocial.com/papers/698828850fc35cd7a8848166https://doi.org/10.1093/eurheartj/ehaf784.2480
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Also Consider

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

  1. 1Functional and Morphological Determinants of Left Ventricular Fibrosis in Patients with Mitral Annular Disjunction in Cardiac Magnetic Resonance Imaging2025
  2. 2Functional and morphological predictors of left ventricular fibrosis in patients with mitral annular disjunction in cardiac magnetic resonance imaging2025 · 1 citations
  3. 3Prevalence and cardiovascular implications of mitral valve prolapse in marfan syndrome: insights from a multicenter observational study2025
  4. 4Association of Mitral Annular Disjunction With Cardiovascular Outcomes Among Patients With Marfan Syndrome2021 · 52 citations
  5. 5Evaluation of left ventricular function in patients with mitral annular disjunction using speckle tracking echocardiography2024 · 4 citations