Valvular & structural heart disease
Abnormal Mechanics Relate to Myocardial Fibrosis and Ventricular Arrhythmias in Patients With Mitral Valve Prolapse
Authors' conclusion
Basal inferior-posterior myocardial fibrosis in MVP is associated with abnormal MVP-related myocardial mechanics, which are potentially associated with ventricular arrhythmia.
Study context
- Population
- Patients with mitral valve prolapse with echocardiogram and gadolinium CMR
- Participants
- 113 patients
- Exposure
- Mitral valve prolapse (MVP) with vs without myocardial fibrosis
- Fibrosisn = 43
- No MVPn = 20
- Outcome
- Association of abnormal MVP-related mechanics with myocardial fibrosis, and with ventricular arrhythmia (nonsustained or sustained VT or VF)
Main finding
As reported in the abstract
Double-peak inferior-lateral strain pattern
P < 0.001
- Myocardial fibrosis in MVP, mainly basal-midventricular inferior-lateral wall and papillary muscles
- 43
- MVP with fibrosis: greater MR, prolapse, superior papillary muscle displacement with basal curling and more impaired inferior-posterior basal strain vs without fibrosis
- P < 0.001
- Double-peak strain absent in patients without MVP with basal inferior-lateral wall fibrosis
- n=20
Observational data: associations, not effects.
Further findings
Ventricular arrhythmias · median follow-up 1008 days
- Patients with MVP with >6-month follow-up developing ventricular arrhythmias
- 36 of 87
- Univariable association with fibrosis, greater prolapse, mitral annular disjunction and double-peak strain
- Multivariable: double-peak strain showed incremental risk of arrhythmia over fibrosis
Original publication
Abnormal Mechanics Relate to Myocardial Fibrosis and Ventricular Arrhythmias in Patients With Mitral Valve Prolapse. Circ Cardiovasc Imaging. Published 18 April 2023. doi:10.
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