Abstract 15502: Exercise as a Risk Factor for Arrhythmic Mitral Valve Prolapse

Abstract

Background: Mitral valve prolapse (MVP) is a common valvular abnormality found in approximately 2.4% of the population. Whereas most cases are benign, an increasingly recognized sequela of MVP is sudden cardiac death (SCD), but risk factors for SCD are not well-defined. Exercise has not been explored as a potential risk factor for SCD in MVP. Hypothesis: We tested the hypothesis that patients with MVP and SCD would be more likely to exercise or be competitive athletes than MVP controls with the capacity to exercise. Methods - The study population was generated from the Duke Epic EHR and determined by ICD-10 codes for MVP and SCD. A comparison group of patients with MVP with exercise data was used. Patients were included if they had guideline-based diagnosis of MVP on echocardiogram or cardiac magnetic resonance imaging. Exercise <1 hour per week was defined as being sedentary and time >1 hour per week or status as a competitive athletes were defined as habitual exercisers. Results: Of the 27 patients with MVP and SCD 18 had documentation of exercise time per week. There were 42 in the control group. Patients with SCD were younger [(54.8 +/-15.1) vs. (63.9 +/- 14.1) p= 0.03], and more likely to have bileaflet prolapse [13/18 (72%) vs. 15/42 (36%), p=0.01]. Patients with SCD were more likely to be habitual exercisers vs. sedentary [16/18 (89%) vs. 17/42 (40.5%), p = .025]. 20 patients with MVP and SCD had documentation of activity level at the time of event. 10 were exercising (50%), 5 (25%) working or doing housework, 4 (20%) resting and 1 (5%) sleeping. Conclusion: Exercise time >1 hour per week is associated with sudden cardiac death in Mitral Valve Prolapse. Exercise may be a trigger of SCD; however, more data is needed to better characterize exercise as a risk factor for SCD in this population.