Arrhythmias & electrophysiologyCohort study
Impact of Myocardial Fibrosis and Female Sex on Life-Threatening Arrhythmias and Sudden Cardiac Death in Mitral Valve Prolapse
- prospective cohort study
- consecutive patients
- tertiary academic center
Authors' conclusion
In a large prospective cardiovascular magnetic resonance cohort of patients with MVP, female sex and myocardial fibrosis were each independently associated with life-threatening arrhythmic events. Their combination identified a subgroup at particularly elevated risk, highlighting the importance of integrating sex-specific factors and myocardial tissue characterization into MVP risk stratification strategies.
Study context
- Population
- Patients with mitral valve prolapse (MVP) referred for cardiovascular magnetic resonance, excluding coronary artery disease, cardiomyopathy, infiltrative disease or prior cardiac surgeryconsecutive patients with MVP, median age 62 years, 50% women
- Participants
- 550 patients
- Exposure
- female sex and late gadolinium enhancement (LGE) presence as risk factors for arrhythmic events
- LGE presentn = 210
- Outcome
- Composite arrhythmic outcome:
- Sudden cardiac death
- Aborted sudden cardiac arrest
- Symptomatic sustained or inducible ventricular tachycardia or ventricular fibrillation leading to implantable cardioverter defibrillator placement or ventricular ablation at an MVP-related scar site
- Follow-up
- Median 4.4 years (interquartile range, 2.8-7.1; 2700 patient-years)
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
female sex
3.33(1.72–6.44)
P < 0.001LGE presence
3.17(1.74–5.77)
P < 0.001- Patients reaching the primary end point
- 48 patients (8.7%)
Observational data: associations, not effects.
Further findings
| Outcome | LGE present | Women with LGE | Men without LGE |
|---|---|---|---|
| 5-year event-free survival (subgroup) · Women with LGE represented the highest-risk subgroup | Not reported in the abstract | 76.5% | 98.5% |
- 5-year event-free survival (subgroup): P <0.001
Original publication
Impact of Myocardial Fibrosis and Female Sex on Life-Threatening Arrhythmias and Sudden Cardiac Death in Mitral Valve Prolapse. Circ Cardiovasc Imaging. Published 4 August 2026. doi:10.1161/circimaging.126.020017
Summarised from the published abstract; every number is checked against it