Abstract
Abstract Background Mitral valve prolapse (MVP) is considered a benign disorder, though it can be accompanied by ventricular arrhythmias. Speckle Tracking Echocardiography can be a promising tool for detecting early derangement. Objectives To determine whether the left ventricular (LV) mechanical dispersion derived by speckle tracking echocardiography can be considered a predictor for occurrence of ventricular arrhythmias in patients with MVP. Materials and Methods A cross-sectional study conducted on 63 MVP patients (37 females and 29 males) presented with palpitation, who were divided into two groups: Group 1 Arrhythmic patients with ventricular arrhythmias and Group 2 Non-Arrhythmic patients. All of them underwent comprehensive clinical and electrocardiographic examination, cardiac rhythm assessment by Holter monitoring, and comprehensive echocardiographic evaluation including speckle tracking technique. Results Ventricular arrhythmias (VA) were detected in 32 out of 63 patients. Ventricular bigeminy was the most common type of VA in arrhythmic patients. Unlike other echocardiographic parameters, the LV mechanical dispersion (MD) and the mitral annular disjunction (MAD) were found to be significantly higher in arrhythmic versus non-arrhythmic MVP patients (P<0.001). Furthermore, the mean LV MD was higher in patients with frequent ventricular ectopics versus infrequent ones (P= 0.003). The cut-off value for LV MD was 35.1 ms or higher (sensitivity 87%, specificity 71%) and for MAD was 2.7 mm or higher (sensitivity 82%, specificity 60%) in predicting VA in MVP patients. Conclusions LV mechanical dispersion in addition to MAD can be implemented in risk prediction for ventricular arrhythmias in patients with MVP presenting with palpitations.
Published Version
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