Predictors of ventricular arrhythmias in patients with mitral valve prolapse

Türker, Yasin; Özaydın, Mehmet; Acar, Gürkan; Özgül, Mustafa; Hoşcan, Yeşim; Varol, Ercan; Doğan, Abdullah; Erdoğan, Doğan; Yücel, Habil

doi:10.1007/s10554-009-9514-6

Cited by 54 publications

(43 citation statements)

References 30 publications

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“…MVP patients have a prevalence of ventricular arrhythmias as high as 34% with premature ventricular contractions (PVCs) as the most common pattern (66% of cases) (10). Moderate-to-severe MR has been demonstrated to be an independent risk factor for generating arrhythmias (1,11). Early repolarization has also been associated with MVP (1).…”

Section: Causes Of Scdmentioning

confidence: 99%

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

et al. 2017

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Mitral valve prolapse (MVP) is a common valve abnormality in general population. Despite the general belief of a benign disorder, several articles since the 1980s report sudden cardiac death (SCD) in MVP patients, with a substantial percentage of asymptomatic young individuals. The problem is to detect those patients at increased risk and implement methods that are suitable to prevent cardiac arrest. This review investigates the correlation between MVP and SCD, the understanding of the pathophysiology, the strategies for detecting those at risk and treatment options. A complete literature survey was performed using PubMed database search to gather available information regarding MVP and SCD. A total of 33 studies met selection criteria for inclusion in the review. MVP is an underrated cause of arrhythmic SCD. The subset of patients with malignant MVP who may be at greater risk for SCD is characterized by young women with bileaflet MVP, biphasic or inverted T waves in the inferior leads, and frequent complex ventricular ectopic activity with documented ventricular bigeminy or ventricular tachycardia (VT) and premature ventricular contractions (PVCs) configurations of outflow tract alternating with fascicular origin or papillary muscle. MVP is a common condition in the general population and is often encountered in asymptomatic individuals. The existing literature continues to generate significant controversy regarding the association of MVP with ventricular arrhythmias and SCD. Early echocardiography and cardiac magnetic resonance (CMR) are essential, as is a greater understanding of the potential electrophysiological processes of primary arrhythmogenesis and the evaluation of the genetic substrate.

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Section: Causes Of Scdmentioning

confidence: 99%

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

et al. 2017

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“…Nevertheless, these studies pointed for a subgroup of MVP patients experiencing SCD who were typically young and asymptomatic; many of whom had a preserved LVEF and no significant MR. Notably, although significant MR was found to predict ventricular arrhythmia among MVP patients in some studies [4,7] this was not shown by others [1][2][3]8].…”

mentioning

confidence: 79%

“…The association of mitral valve prolapse (MVP) with ventricular arrhythmias and sudden cardiac death (SCD) has been recognized for few decades [1][2][3][4][5][6]. Nevertheless, until recently this association has been mainly a vague one; with not much of an evidence to estimate its prevalence, clarify if this is a mere association or a causative effect, understand the mechanism underlying this association and hence risk stratify these patients.…”

Section: Introductionmentioning

confidence: 99%

Sudden Cardiac Death in Mitral Valve Prolapse: Are we ready for Risk Stratification?

M¹,

Wolak²

2017

JCCR

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“…Some studies suggested that MVP patients with MR are more prone to ventricular arrhythmias than those without MR. In a study that evaluated the predictors of ventricular arrhythmias in patients with MVP, the authors speculated that the only independent predictor of ventricular arrhythmia was the occurrence of moderate to severe MR [12]. In another study, patients with complex ventricular arrhythmias frequently had MR [34].…”

Section: Discussionmentioning

confidence: 99%

“…Although some previous studies demonstrate an association between lifethreatening ventricular arrhythmias and moderate to severe mitral regurgitation, life-threatening ventricular arrhythmias also occur in patients with MVP in the absence of mitral regurgitation (MR) [11][12][13][14]. By using a 12-lead surface electrocardiogram (ECG), researchers have demonstrated susceptibility to ventricular arrhythmogenesis in patients with MVP [15,16].…”

Section: Introductionmentioning

confidence: 99%

Prolonged Tp–e Interval and Tp–e/QT Ratio in Children with Mitral Valve Prolapse

et al. 2016

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Although it is considered to be a benign condition, previous studies have shown that a subset of patients with mitral valve prolapse (MVP) may be at risk of ventricular arrhythmia and sudden cardiac death (SCD). Previous studies have suggested that the interval between the peak and the end of the T wave (Tp-e) can be used as a marker for the transmural dispersion of repolarization. Increased Tp-e interval and Tp-e/QT ratio are associated with ventricular arrhythmias and SCD. The aim of this study was to assess alterations in ventricular repolarization by using the Tp-e interval and Tp-e/QT ratio in children with MVP and to investigate their relationships with the degree of valvular regurgitation. This study prospectively investigated 110 children with MVP and 107 age- and sex-matched healthy control subjects. Tp-e interval, Tp-e/QT ratio, and QT and QTc dispersions were measured from a 12-lead electrocardiogram and compared between groups. QT and QTc dispersions, Tp-e interval, and Tp-e/QTc ratio were found to be significantly higher in patients with MVP. A positive correlation was found between Tp-e/QTc ratio and increase in the degree of mitral regurgitation (MR) (p < 0.05; r = 0.2). However, the degree of MR was not associated with QT, QTc, or Tp-e intervals; QT, QTc, or Tp-e dispersions; or Tp-e/QT ratio (all p values >0.05). Individuals with MVP may be more prone to ventricular arrhythmias due to prolonged QTd, QTcd, and Tp-e interval and increased Tp-e/QT and Tp-e/QTc ratios. Therefore, due to their longer life expectancy, children with MVP should be followed up on regarding life-threatening arrhythmias.

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Predictors of ventricular arrhythmias in patients with mitral valve prolapse

Cited by 54 publications

References 30 publications

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

Mitral valve prolapse: an underestimated cause of sudden cardiac death—a current review of the literature

Sudden Cardiac Death in Mitral Valve Prolapse: Are we ready for Risk Stratification?

Prolonged Tp–e Interval and Tp–e/QT Ratio in Children with Mitral Valve Prolapse

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