Clinical characteristics of patients with arrhythmic mitral valve prolapse in a single tertiary center: prevalence of electrocardiographic and myocardial abnormalities

Zienciuk-Krajka, Agnieszka; Daniłowicz‐Szymanowicz, Ludmiła; Dorniak, Karolina; Owczuk, Radosław; Kaufmann, Damian; Zacharek, Dariusz; Dąbrowska−Kugacka, Alicja; Figura-Chmielewska, Monika; Nowak, Radosław; Kempa, Maciej; Kuźmiński, Piotr; Raczak, Grzegorz

doi:10.33963/kp.a2021.0008

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…The main risk factors include leaflet thickness >5 mm, bileaflet prolapse, papillary muscle fibrosis, and mitral annular disjunction [1,2]. Zienciuk-Krajka et al [3] recently reported that among patients with arrhythmic mitral valve prolapse, survivors of cardiac arrest had a higher E/e' ratio. Myocardial work represents a relatively new echocardiographic parameter.…”

mentioning

confidence: 99%

Malignant arrhythmia associated with mitral annular disjunction: Myocardial work as a potential tool in the search for a substrate

et al. 2022

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mentioning

confidence: 99%

Malignant arrhythmia associated with mitral annular disjunction: Myocardial work as a potential tool in the search for a substrate

et al. 2022

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“…It has been proven that patients with Pickelhaube's sign are in higher risk group, which encounters VAs and has a visible focal fibrosis on CMR. The study of Zienciuk-Krajka et al [59], examined patients with malignant type of MVP. They were divided into two groups based on the occurrence of CA in their medical history.…”

Section: Picklehaube's Signmentioning

confidence: 99%

“…It is believed to result in a spontaneous diastolic depolarization and an abnormal automaticity. The study of Zienciuk-Krajka et al [59] was the first research, which noted the association between a high E/e' ratio and the SCD risk.…”

Section: Picklehaube's Signmentioning

confidence: 99%

Mitral valve prolapse—arrhythmic faces of the valve disease

Możdżan,

Duraj

et al. 2023

Explor Cardiol

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Mitral valve prolapse (MVP) is a relatively common mitral valvulopathy and the most common cause of isolated primary mitral regurgitation (MR) requiring surgical repair. It affects about 1–3% of the general population. Although MVP is viewed as a benign condition, the association between MVP and sudden cardiac death (SCD) has been proven. Patients with MVP have a three times higher risk of SCD than the general population. The underlying mechanisms and predictors of arrhythmias, which occur in patients with MVP, are still poorly understood. However, some echocardiographic features such as mitral annulus disjunction (MAD), bileaflet MVP (biMVP), and papillary muscle (PM) fibrosis were frequently linked with increased number of arrhythmic events and are referred to as “arrhythmogenic” or “malignant”. Arrhythmogenic MVP (AMVP) has also been associated with other factors such as female sex, polymorphic premature ventricular contraction (PVC), abnormalities of T-waves, and Pickelhaube sign on tissue Doppler tracing of the lateral part of the mitral annulus. Cardiac magnetic resonance (CMR) imaging and speckle tracking echocardiography are new tools showing significant potential for detection of malignant features of AMVP. This paper presents various data coming from electrocardiography (ECG) analysis, echocardiography, and other imaging techniques as well as compilation of the recent studies on the subject of MVP.

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“…Since CMR is not a widespread diagnostic tool, finding noninvasive techniques easily performed in routine clinical practice, which could help identify MVP patients with a morphological substrate for VAs, is of great clinical importance [31]. Twodimensional (2D) transthoracic echocardiography is unquestionably the first-step imaging modality for MVP diagnosis, and assessing its structural characteristics [16,23,32]. The length of the MAD, curling visualization, and the Pickelhaube sign are proposed to be the feature of the arrhythmic MVP phenotype in standard 2D echocardiography [33,34].…”

Section: Introductionmentioning

confidence: 99%

Left Ventricle Segmental Longitudinal Strain and Regional Myocardial Work Index Could Help Determine Mitral Valve Prolapse Patients with Increased Risk of Ventricular Arrhythmias

Daniłowicz‐Szymanowicz

Zienciuk-Krajka

Wabich

et al. 2023

JCDD

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Mitral valve prolapse (MVP) could associate with malignant ventricular arrhythmias (VAs). Mitral annular disjunction, a putative mechanism for an arrhythmic substrate, leads to excessive mobility, stretch, and damage of some segments. Speckle tracking echocardiography (STE), with particular attention to the segmental longitudinal strain and myocardial work index (MWI), could be an indicator of the segments we aimed to check. Seventy-two MVP patients and twenty controls underwent echocardiography. Complex VAs documented prospectively after the enrollment was qualified as the primary endpoint, which was noticed in 29 (40%) patients. Pre-specified cut-off values for peak segmental longitudinal strain (PSS) and segmental MWI for basal lateral (−25%, 2200 mmHg%), mid-lateral (−25%, 2500 mmHg%), mid-posterior (−25%, 2400 mmHg%), and mid-inferior (−23%, 2400 mmHg%) segments were accurate predictors of complex VAs. A combination of PSS and MWI increased the probability of the endpoint, reaching the highest predictive value for the basal lateral segment: odds ratio 32.15 (3.78–273.8), p < 0.001 for PSS ≥ −25% and MWI ≥ 2200 mmHg%. STE may be a valuable tool for assessing the arrhythmic risk in MVP patients. Excessively increased segmental longitudinal strain with an augmented regional myocardial work index identifies patients with the highest risk of complex VAs.

show abstract

Clinical characteristics of patients with arrhythmic mitral valve prolapse in a single tertiary center: prevalence of electrocardiographic and myocardial abnormalities

Cited by 4 publications

References 10 publications

Malignant arrhythmia associated with mitral annular disjunction: Myocardial work as a potential tool in the search for a substrate

Malignant arrhythmia associated with mitral annular disjunction: Myocardial work as a potential tool in the search for a substrate

Mitral valve prolapse—arrhythmic faces of the valve disease

Left Ventricle Segmental Longitudinal Strain and Regional Myocardial Work Index Could Help Determine Mitral Valve Prolapse Patients with Increased Risk of Ventricular Arrhythmias

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