Purpose
To evaluate the ECG,
TEE and CMR characteristics of patients with bileaflet mitral valve prolapse (MVP) in order to identify the sub-population at risk of arrhythmic events.
Methods and Materials
Patients admitted to our cardiology department for out-of-hospital hearth attack,
arrhythmic syncope or complex ventricular arrhythmia were enrolled.
Between those patients,
only cases with MVP as unique possible cause were selected (arrhythmic patients).
They were re-examined and compared to a control group formed by patients with MVP without cardiac arrhythmias (non-arrhythmic patients).
Holter-ECG,
TEE and CMR were performed in every patient.
Data were analyzed with non-parametric tests.
Results
Nine arrhythmic patients (mean age 40±10 years) and five non-arrhythmic patients (mean age 38±11 years) with MVP were enrolled.
The frequency of premature ventricular contractions (PVCs) was higher in the arrhythmic group (p=0.02),
while the other ECG parameters weren’t significantly different between the two groups (p>0.05).
Regarding TEE and CMR characteristics,
mitral annulus disjunction and prevalence of posterior systolic curling were higher in the arrhythmic group (p=0.045); annular hypermobility,
myxomatous leaflet,
lengths of MV leaflets and of chordae tendineae weren’t different (p>0.05).
Left ventricular late...
Conclusion
Premature ventricular contractions,
mitral annulus disjunction and posterior systolic curling were associated to the presence of arrhythmic events in patients with MVP.
There was no significantdifference in the prevalence of myocardial fibrosis between patients with or without arrhythmic events.
References
Silbiger JJ - Anatomy,
mechanics,
and pathophysiology of the mitral annulus - Am Heart J. 2012 Aug;164(2):163-76
Basso C,
Perazzolo Marra M,
Rizzo S,
De Lazzari M,
Giorgi B,
Cipriani A,
Frigo AC,
Rigato I,
Migliore F,
Pilichou K,
Bertaglia E,
Cacciavillani L,
Bauce B,
Corrado D,
Thiene G,
Iliceto S - Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death - Circulation.
2015 Aug 18;132(7):556-66
Perazzolo Marra M,
Basso C,
De Lazzari M,
Rizzo S,
Cipriani A,
Giorgi B,
Lacognata C,
Rigato I,
Migliore F,...