Mitral valve repair results in suppression of ventricular arrhythmias and normalization of repolarization abnormalities in mitral valve prolapse

Alqarawi, Wael; Birnie, David H.; Burwash, Ian G.

doi:10.1016/j.hrcr.2018.02.012

Cited by 15 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TWI in inferior and lateral leads may be an electrical manifestation of myocardial distress secondary to stretch stress, rather than the expression of a structural abnormality. This hypothesis is supported by findings from Alqarawi et al, 26 who reported the normalization of TWI after mitral valve repair. Chivulescu et al 27 also found an increased risk of complex VA in MVP patients with a more extensive TWI, showing the correlation between TWI, the percentage of extracellular volume by T1 mapping at CMR, and VAs 28 .…”

Section: Discussionsupporting

confidence: 76%

Arrhythmic risk profile in mitral valve prolapse: A systematic review and metanalysis of 1715 patients

Pistelli,

Vetta,

Parlavecchio

et al. 2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

IntroductionMitral valve prolapse (MVP) is a common clinical condition in the general population. A subgroup of patients with MVP may experience ventricular arrhythmias and sudden cardiac death (“arrhythmic mitral valve prolapse” [AMVP]) but how to stratify arrhythmic risk is still unclear. Our meta‐analysis aims to identify predictive factors for arrhythmic risk in patients with MVP.MethodsWe systematically searched Medline, Cochrane, Journals@Ovid, Scopus electronic databases for studies published up to December 28, 2022 and comparing AMVP and nonarrhythmic mitral valve prolapse (NAMVP) for what concerns history, electrocardiographic, echocardiographic and cardiac magnetic resonance features. The effect size was estimated using a random‐effect model as odds ratio (OR) and mean difference (MD).ResultsA total of 10 studies enrolling 1715 patients were included. Late gadolinium enhancement (LGE) (OR: 16.67; p = .005), T‐wave inversion (TWI) (OR: 2.63; p < .0001), bileaflet MVP (OR: 1.92; p < .0001) and mitral anulus disjunction (MAD) (OR: 2.60; p < .0001) were more represented among patients with AMVP than in NAMVP. Patients with AMVP were shown to have longer anterior mitral leaflet (AML) (MD: 2.63 mm; p < .0001), posterior mitral leaflet (MD: 2.96 mm; p < .0001), thicker AML (MD: 0.49 mm; p < .0001), longer MAD length (MD: 1.24 mm; p < .0001) and higher amount of LGE (MD: 1.41%; p < .0001) than NAMVP. AMVP showed increased mechanical dispersion (MD: 8.04 ms; 95% confidence interval: 5.13–10.96; p < .0001) compared with NAMVP.ConclusionsOur meta‐analysis proved that LGE, TWI, bileaflet MVP, and MAD are predictive factors for arrhythmic risk in MVP patients.

show abstract

Section: Discussionsupporting

confidence: 76%

Arrhythmic risk profile in mitral valve prolapse: A systematic review and metanalysis of 1715 patients

Pistelli,

Vetta,

Parlavecchio

et al. 2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…Our patient also presented, soon after hospitalization and until operation, T wave inversion in the inferior ECG leads, which was reported as highly prevalent in patients with MVP and cardiac arrest [3], and is strongly associated with VA [7]. Interestingly, these ECG abnormalities disappeared soon after mitral valve repair, suggesting that LV volume overload reduction or the relief of the mitral valve apparatus stretching after operation can normalize these ECG changes, as also reported by Alqarawi et al [11].…”

Section: Risk Stratification For Ventricular Arrhythmias In Mvp Patientssupporting

confidence: 85%

Malignant Arrhythmic Mitral Valve Prolapse: A Continuum of Clinical Challenges from Diagnosis to Risk Stratification and Patient Management

Yedidya

Wijngaarden

Marsan

2020

JCDD

View full text Add to dashboard Cite

Mitral valve prolapse (MVP) is a common valvular disease, which may remain a benign condition for a long period of time. However, some patients experience malignant ventricular arrhythmias and sudden cardiac death (SCD). It is still largely unknown how to risk-stratify these patients, and no specific recommendations have been proposed to help the clinical decision-making. We present the case of a young man whose first clinical presentation was an out-of-hospital cardiac arrest and was subsequently diagnosed with MVP. We highlighted the possible risk factors for SCD and the challenges in the clinical management of these patients.

show abstract

“…Surgical intervention for AMVP remains controversial and limited to small case series and reports. [181][182][183][184][185][186][187][188] While surgical correction of severe MR tends to reduce VA burden in patients with MVP and degenerative MR, 14,189 results are inconsistent. 171,190 The respective role of various surgical procedures (repair/replacement, valve tissue resection etc.)…”

Section: Role Of Valve Surgerymentioning

confidence: 99%

EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society

Sabbag

Essayagh

Barrera³

et al. 2022

EP Europace

111

144

View full text Add to dashboard Cite

Risk stratification scheme. Risk stratification aiming at assessing the risk of VAs and SCD in patients with MVP, involving two phases based on the clinical and imaging context and the uncovered arrhythmia. In the absence of ventricular tachycardia, phenotypic risk features will trigger the intensity of screening for arrhythmia. Green boxes indicate green heart consensus statements and yellow boxes indicate yellow heart consensus statements. High risk -sustained VT, polymorphic NSVT, fast (>180 bpm) NSVT, VT/NSVT resulting in syncope. ICD = implantable cardioverter defibrillator; LA = left atrium; LGE = late gadolinium enhancement; LV-EF = left ventricular ejection fraction; MAD = mitral annular disjunction; MV = mitral valve; PVCs = premature ventricular contractions; TWI = T-wave inversion; VT = ventricular tachycardia. #Additional ECG monitoring method may be used such as loop recorders.

show abstract

Mitral valve repair results in suppression of ventricular arrhythmias and normalization of repolarization abnormalities in mitral valve prolapse

Cited by 15 publications

References 14 publications

Arrhythmic risk profile in mitral valve prolapse: A systematic review and metanalysis of 1715 patients

Arrhythmic risk profile in mitral valve prolapse: A systematic review and metanalysis of 1715 patients

Malignant Arrhythmic Mitral Valve Prolapse: A Continuum of Clinical Challenges from Diagnosis to Risk Stratification and Patient Management

Contact Info

Product

Resources

About