Mitral valve prolapse in sudden cardiac arrest survivors - coincidence or causal relationship?

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-01-07 DOI:10.1016/j.hrthm.2024.12.042

Krzysztof Jaworski, Ilona Kowalik, Bohdan Firek, Hubert Lazarczyk, Rafal Baranowski, Zofia Bilinska, Elzbieta Katarzyna Biernacka, Tomasz Hryniewiecki, Magdalena Marczak, Mateusz Spiewak, Anna Konopka, Michal Lewandowski, Pawel Syska, Mariusz Pytkowski, Maciej Sterlinski, Lukasz Szumowski, Rafal Dabrowski

{"title":"Mitral valve prolapse in sudden cardiac arrest survivors - coincidence or causal relationship?","authors":"Krzysztof Jaworski, Ilona Kowalik, Bohdan Firek, Hubert Lazarczyk, Rafal Baranowski, Zofia Bilinska, Elzbieta Katarzyna Biernacka, Tomasz Hryniewiecki, Magdalena Marczak, Mateusz Spiewak, Anna Konopka, Michal Lewandowski, Pawel Syska, Mariusz Pytkowski, Maciej Sterlinski, Lukasz Szumowski, Rafal Dabrowski","doi":"10.1016/j.hrthm.2024.12.042","DOIUrl":null,"url":null,"abstract":"Background: Sudden cardiac arrest (SCA) risk stratification in patients with mitral valve prolapse (MVP) may be complicated by other potential causes of arrhythmia.Objectives: We aimed to characterize SCA survivors with isolated (iMVP) and non-isolated MVP (non-iMVP) and to assess their long-term follow-up.Methods: This ambispective study included 75 patients with MVP who experienced SCA and were treated in our center between 2009-2024. They were divided into three groups depending on probability of relation between SCA and comorbidities. The control group comprised 112 subjects with MVP but without a history of SCA. We analyzed all available electrocardiograms, Holter ECG monitoring and echocardiograms, including longitudinal strain. A novel parameter, the systolic atrial-directed notch (SADN) was tested.Results: SCA survivors with iMVP (n=28) had higher prevalence of mitral annular disjunction (MAD) (80% vs. 35.7%, P=0.006), Pickelhaube sign (60% vs. 8.3%, P=0.008), SADN > 2 mm (69.6% vs. 14.3%, P=0.001) as well as higher absolute longitudinal strain values in basal and mid segments of inferior and inferolateral wall than patients with SCA and non-iMVP without other defined structural heart diseases (SHD(-)) (n=14). The differences were also observed in comparison to control group. The cumulative incidence of appropriate implantable cardioverter-defibrillator shocks within 6 years was 62% in patients with iMVP and 23% in the group with non-iMVP SHD(-).Conclusions: Echocardiographic findings such as MAD, SADN, Pickelhaube sign and increased segmental strain may be useful in the assessment of relation between SCA and MVP. Malignant arrhythmias often recur in SCA survivors with iMVP.","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.12.042","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Sudden cardiac arrest (SCA) risk stratification in patients with mitral valve prolapse (MVP) may be complicated by other potential causes of arrhythmia.

Objectives: We aimed to characterize SCA survivors with isolated (iMVP) and non-isolated MVP (non-iMVP) and to assess their long-term follow-up.

Methods: This ambispective study included 75 patients with MVP who experienced SCA and were treated in our center between 2009-2024. They were divided into three groups depending on probability of relation between SCA and comorbidities. The control group comprised 112 subjects with MVP but without a history of SCA. We analyzed all available electrocardiograms, Holter ECG monitoring and echocardiograms, including longitudinal strain. A novel parameter, the systolic atrial-directed notch (SADN) was tested.

Results: SCA survivors with iMVP (n=28) had higher prevalence of mitral annular disjunction (MAD) (80% vs. 35.7%, P=0.006), Pickelhaube sign (60% vs. 8.3%, P=0.008), SADN > 2 mm (69.6% vs. 14.3%, P=0.001) as well as higher absolute longitudinal strain values in basal and mid segments of inferior and inferolateral wall than patients with SCA and non-iMVP without other defined structural heart diseases (SHD(-)) (n=14). The differences were also observed in comparison to control group. The cumulative incidence of appropriate implantable cardioverter-defibrillator shocks within 6 years was 62% in patients with iMVP and 23% in the group with non-iMVP SHD(-).

Conclusions: Echocardiographic findings such as MAD, SADN, Pickelhaube sign and increased segmental strain may be useful in the assessment of relation between SCA and MVP. Malignant arrhythmias often recur in SCA survivors with iMVP.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.