Ventricular arrhythmias in syndrome of balloon deformity of mitral valve. Definition of possible high risk group.

Campbell, R. W. F.; Godman, Michael G.; Fiddler, G I; Marquis, R. M.; Julian, D G

doi:10.1136/hrt.38.10.1053

Cited by 92 publications

(9 citation statements)

References 23 publications

(27 reference statements)

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“…Boudoulas et al [412] and Campbell et al [414] found that infero-lateral ST segment changes were associated with the presence of ventricular tachycardia or fibrillation. It was concluded from other studies that prolongation of QT interval and increased QT dispersion might be useful markers of arrhythmic mortality [415,416] .…”

Section: Sudden Cardiac Death 1411mentioning

confidence: 99%

Task Force on Sudden Cardiac Death of the European Society of Cardiology

Priori

Aliot

Blomström‐Lundqvist

et al. 2001

European Heart Journal

771

445

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Section: Sudden Cardiac Death 1411mentioning

confidence: 99%

Task Force on Sudden Cardiac Death of the European Society of Cardiology

Priori

Aliot

Blomström‐Lundqvist

et al. 2001

European Heart Journal

771

445

View full text Add to dashboard Cite

“…SCA has been described as one of the possible outcomes on follow-up in MVP 4, 5 and several instances of SCA in young patients with MVP have been reported 6, 7 . Additionally, occurrence of ventricular arrhythmias on resting or ambulatory electrocardiograms is reported to be higher among patients with MVP 8, 9 though some studies have disputed this finding 10 . Conversely, other natural history studies indicate that MVP may have a benign prognosis 2, 4 .…”

Section: Introductionmentioning

confidence: 99%

Mitral valve prolapse and sudden cardiac arrest in the community

et al. 2016

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Background Mitral valve prolapse (MVP) is relatively common in the general population with recently reported prevalence of 1% and familial clustering (Framingham Heart Study). However, the association with ventricular arrhythmias and sudden cardiac arrest (SCA) remains controversial. Objective To ascertain the frequency of MVP among SCA cases in the community and characterize the clinical profile of SCA cases with MVP Methods SCA cases were prospectively identified in the population-based, Oregon Sudden Unexpected Death Study (population approximately 1 million). Presence of MVP was identified from echocardiograms performed prior but unrelated to the SCA event. The detailed clinical profile of SCA cases with MVP was compared to those without MVP to identify potential differences. Results 729 SCA cases were evaluated over a 12 year period (69.5 ± 14.8 years; 64.6% male). MVP was seen in 17 cases pre-arrest (2.3%; 95% CI 1.2 to 3.4%). Mitral regurgitation (MR) was present in 14 (82.3%) MVP-SCA cases, and was moderate or severe in 10 (58.8%). Compared to cases without MVP, MVP-SCA cases were younger (60.9 ± 16.4 vs 69.7 ± 14.7; p=0.02), with fewer risk factors (diabetes 5.9% vs 46.4%; p=0.001; hypertension 41.2% vs 78.9%; p=0.001) or known coronary disease (29.4% vs 65.6%; p<0.001). Conclusion MVP was observed in a small proportion (2.3%) of SCA cases in the general population, suggesting a low risk overall. Since MVP-SCA cases were characterized by younger age and relatively low cardiovascular comorbidity, a focus on imaging for valve structure/insufficiency, as well as genetics could aid future risk stratification approaches.

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“…5,9,10,[28][29][30][31][32][33][34][35] In particular, the clinical evidence of hemodynamically important regurgitation greatly affects the occurrence of ventricular arrhythmias. However, the detection of MVP in survivors of life-threatening arrhythmias suggests that a true association between hemodynamically uncomplicated MVP and arrhythmic SCD may exist.…”

Section: Ventricular Arrhythmias In Mvpmentioning

confidence: 99%

Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death

et al. 2015

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Background— Mitral valve prolapse (MVP) may present with ventricular arrhythmias and sudden cardiac death (SCD) even in the absence of hemodynamic impairment. The structural basis of ventricular electric instability remains elusive. Methods and Results— The cardiac pathology registry of 650 young adults (≤40 years of age) with SCD was reviewed, and cases with MVP as the only cause of SCD were re-examined. Forty-three patients with MVP (26 females; age range, 19–40 years; median, 32 years) were identified (7% of all SCD, 13% of women). Among 12 cases with available ECG, 10 (83%) had inverted T waves on inferior leads, and all had right bundle-branch block ventricular arrhythmias. A bileaflet involvement was found in 70%. Left ventricular fibrosis was detected at histology at the level of papillary muscles in all patients, and inferobasal wall in 88%. Living patients with MVP with (n=30) and without (control subjects; n=14) complex ventricular arrhythmias underwent a study protocol including contrast-enhanced cardiac magnetic resonance. Patients with either right bundle-branch block type or polymorphic complex ventricular arrhythmias (22 females; age range, 28–43 years; median, 41 years), showed a bileaflet involvement in 70% of cases. Left ventricular late enhancement was identified by contrast-enhanced cardiac magnetic resonance in 93% of patients versus 14% of control subjects ( P <0.001), with a regional distribution overlapping the histopathology findings in SCD cases. Conclusions— MVP is an underestimated cause of arrhythmic SCD, mostly in young adult women. Fibrosis of the papillary muscles and inferobasal left ventricular wall, suggesting a myocardial stretch by the prolapsing leaflet, is the structural hallmark and correlates with ventricular arrhythmias origin. Contrast-enhanced cardiac magnetic resonance may help to identify in vivo this concealed substrate for risk stratification.

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Ventricular arrhythmias in syndrome of balloon deformity of mitral valve. Definition of possible high risk group.

Cited by 92 publications

References 23 publications

Task Force on Sudden Cardiac Death of the European Society of Cardiology

Task Force on Sudden Cardiac Death of the European Society of Cardiology

Mitral valve prolapse and sudden cardiac arrest in the community

Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death

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