Determinants of Ventricular Arrhythmias in Mitral Valve Prolapse

• DOI: 10.1016/j.jacep.2023.12.007
• Publication Date: 2024-02-07T19:06:17Z
• Authors: Martina Perazzolo...; Annagrazia Cecere; Alberto Cipriani; Federico Migliore; Alessandro Zorzi; Manuel De Lazzari; Giulia Lorenzoni; Antonella Cecchetto; Giulia Brunetti; Francesca Graziano; Raimondo Pittorru; Raffaella Motta; Giorgio De Conti; Barbara Bauce; Domenico Corrado; Dario Gregori; Sabino Iliceto
• Keywords: Mitral valve prolapse

Mitral valve prolapse (MVP) may be associated with ventricular arrhythmias (VA) even in the absence of significant valvular regurgitation. Curling, mitral annulus disjunction (MAD) and myocardial fibrosis (late gadolinium enhancement [LGE]) account for arrhythmogenesis. This study investigated determinants VA patients MVP without included 108 (66 female; median age: 48 years) All underwent 12-lead electrocardiography, 24-hour electrocardiographic Holter monitoring, exercise stress test, cardiac magnetic resonance. Patients were divided into 2 groups (arrhythmic no-arrhythmic MVP), according to presence a right bundle branch block pattern. The 62 (57%) arrhythmic showed: 1) higher MAD (median length: 6.0 vs 3.2 mm; P = 0.017); 2) prevalence curling (79% 52%; 0.012); 3) left LGE 0.012). Mediation analysis showed that had both direct (P 0.03) indirect effect mediated by 0.04) on VA, whereas association between was completely LGE. severe more pronounced morphofunctional alterations, terms (7.0 4.6 0.004) severity (respectively, 91% 64%; 0.010; 4 3 0.004), compared those VA. In occurrence morphology is expression morphologic, mechanical, tissue alterations. Curling has an