Fibrosis of the papillary muscles and inferobasal left ventricular wall is the structural hallmark of arrhythmic mitral valve prolapse, which may be identified in vivo using contrast-enhanced cardiac magnetic resonance for risk stratification.
MVP is an underestimated cause of arrhythmic SCD, mostly in young adult women. Fibrosis of the papillary muscles and inferobasal left ventricular wall, suggesting a myocardial stretch by the prolapsing leaflet, is the structural hallmark and correlates with ventricular arrhythmias origin. Contrast-enhanced cardiac magnetic resonance may help to identify in vivo this concealed substrate for risk stratification.
Basso et al. (2015) studied this question.