Valvular & structural heart disease
Myocardial work indices in bileaflet mitral valve prolapse patients
Authors' conclusion
Regional differences in MWIs were noted in the BMVP patients compared with controls, with overall reduced myocardial efficiency in the posterolateral trident and basal septal regions. In cross-sectional analysis, MWIs were not different in patients with ventricular tachyarrhythmias.
Study context
- Population
- Patients with bileaflet mitral valve prolapse (59% women, mean age 54 ± 15 years)100 bileaflet mitral valve prolapse (BMVP) vs matched controls
- Participants
- 147 patients
- Comparison
- BMVP patients vs normal controls
- BMVPn = 147
- Outcome
- Global and regional myocardial work index (MWI)
Methodological detailsage- and sex-matched controls
- Age- and sex-matched controls
Main finding
As reported in the abstract
Posterolateral trident myocardial work indices
| Group | Myocardial work | Constructive work | Wasted work | Peak systolic strain | Myocardial work efficiency |
|---|---|---|---|---|---|
| BMVP | 2099 ± 271 mm Hg% | 2831 ± 366 mm Hg% | 87 (52-194) mm Hg% | −23.0 ± 2.4% | 95.00 (93.50-97.75) % |
| Controls | 1895 ± 321 mm Hg% | 2257 ± 338 mm Hg% | 71 (42-103) mm Hg% | −19 ± 3% | 96.75 (95.00-97.75) % |
Myocardial work
BMVP2099 ± 271 mm Hg%
Controls1895 ± 321 mm Hg%
Constructive work
BMVP2831 ± 366 mm Hg%
Controls2257 ± 338 mm Hg%
Wasted work
BMVP87 (52-194) mm Hg%
Controls71 (42-103) mm Hg%
Peak systolic strain
BMVP−23.0 ± 2.4%
Controls−19 ± 3%
Myocardial work efficiency
BMVP95.00 (93.50-97.75) %
Controls96.75 (95.00-97.75) %
- BMVP vs Controls: P = 0.039 — myocardial work
- BMVP vs Controls: P < 0.001 — constructive work
- BMVP vs Controls: P = 0.015 — wasted work
- BMVP vs Controls: P < 0.001 — peak systolic strain
- BMVP vs Controls: P = 0.020 — myocardial work efficiency (reduced)
Observational data: associations, not effects.
Further findings
Myocardial work index (MWIs) in BMVP with flail leaflet
- Higher work indices reduced in those who developed flail leaflets (16 with flail leaflet)
MWIs, ventricular arrhythmia vs no arrhythmia BMVP
- No significant differences in work indices
Original publication
Myocardial work indices in bileaflet mitral valve prolapse patients. Eur Heart J Cardiovasc Imaging. Published 7 December 2023. doi:10.
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