Valvular & structural heart disease
Determinants of Ventricular Arrhythmias in Mitral Valve Prolapse
Authors' conclusion
In patients with MVP the occurrence of VA with right bundle branch block morphology is the expression of more severe morphologic, mechanical, and tissue alterations. Curling has both a direct and an indirect effect on VA.
Study context
- Population
- Patients with mitral valve prolapse (MVP) without significant valve regurgitation (66 female; median age 48 years); all underwent ECG, 24-h Holter, exercise stress test and CMR
- Participants
- 108 patients
- Exposure
- Arrhythmic MVP vs no-arrhythmic MVP
- Arrhythmic MVPn = 62
- Outcome
- Determinants of VA (MAD, curling, LV LGE)
Main finding
As reported in the abstract
Curling
P = 0.012
LV LGE
P = 0.012
mm
| Outcome | Arrhythmic MVP | No-arrhythmic MVP | P value |
|---|---|---|---|
| MAD length (median) | 6.0 | 3.2 | P = 0.017 |
- Mediation: curling had a direct effect on ventricular arrhythmias (VA)
- P = 0.03
- Mediation: curling had an indirect effect on VA mediated by LGE
- P = 0.04
Observational data: associations, not effects.
Further findings
Severe VA vs no severe VA
MAD Severe VA 7.0 mm · No severe VA 4.6 mm · P = 0.004
Curling presence
P = 0.010
Curling severity Severe VA 4 mm · No severe VA 3 mm · P = 0.004
Original publication
Determinants of Ventricular Arrhythmias in Mitral Valve Prolapse. JACC Clin Electrophysiol. Published 7 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it