Abstract
BackgroundAn association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients.MethodsMVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed.ResultsOf the 85 patients [age, 54.0 (41.0–65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65–148.15; P = 0.004], LGE volume (HR 1.08; 95% CI 1.02–1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08–1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model.ConclusionsThe presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.
Highlights
An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA)
85 patients [age, 54.0 (41.0–65.0) years; 46 males] were included; of whom, SCA occurred in 5 patients, sustained ventricular tachycardia occurred during treadmill test in 1 patient, and non-sustained ventricular tachycardia (NSVT) occurred during treadmill test and Holter monitoring in 1 patient during the 7.2 (3.9–9.1) years’ follow-up
The ECG findings revealed no significant differences in the PR interval, QT interval corrected using Bazett’s formula (QTc), and the presence of inverted T wave in the inferior leads, atrial fibrillation, and right bundle brunch block (RBBB) between the groups
Summary
An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients. Mitral valve prolapse (MVP), a common valvular heart disease affects 2–3% of the general population [1, 2]. MVP is generally regarded as a benign condition, a number of studies have reported an association between MVP and sudden cardiac arrest (SCA) [3,4,5,6].
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