心脏骤停幸存者二尖瓣脱垂——巧合还是因果关系？

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-10-01 DOI:10.1016/j.hrthm.2024.12.042

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

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引用次数: 0

摘要

背景：二尖瓣脱垂（MVP）患者的心脏骤停（SCA）风险分层可能并发其他潜在的心律失常原因。目的：我们的目的是描述孤立性（iMVP）和非孤立性MVP（非iMVP）的SCA幸存者的特征，并评估他们的长期随访。方法：本研究纳入了2009-2024年间在我中心治疗的75例经历SCA的MVP患者。根据SCA与合并症之间关系的概率将患者分为三组。对照组包括112例无SCA病史的MVP患者。我们分析了所有可用的心电图、动态心电图监测和超声心动图，包括纵向应变。一个新的参数，收缩期心房定向缺口（SADN）进行了测试。结果：SCA合并iMVP的幸存者（n=28）的二尖瓣环状分离（MAD）（80% vs. 35.7%， P=0.006）、Pickelhaube征（60% vs. 8.3%， P=0.008）、SADN bb2mm （69.6% vs. 14.3%， P=0.001）的发生率高于SCA合并非iMVP且无其他明确结构性心脏病（SHD(-)）的患者（n=14），下壁基底段和中段的绝对纵向应变值也更高。与对照组比较也有差异。在iMVP患者中，6年内适当的植入式心律转复除颤器休克的累计发生率为62%，在非iMVP SHD组中为23%（-）。结论：超声心动图表现如MAD、SADN、Pickelhaube征和节段性应变增加可用于评估SCA与MVP的关系。恶性心律失常常在SCA合并iMVP的幸存者中复发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Mitral valve prolapse in sudden cardiac arrest survivors: Coincidence or causal relationship?

查看原文本刊更多论文

Mitral valve prolapse in sudden cardiac arrest survivors: Coincidence or causal relationship?

Background

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

Objective

We aimed to characterize SCA survivors with isolated MVP (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 and 2024. They were divided into 3 groups according to probability of relation between SCA and comorbidities. The control group comprised 112 participants with MVP but without a history of SCA. We analyzed all available electrocardiograms, Holter electrocardiography 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 (80% vs 35.7%; P = .006), Pickelhaube sign (60% vs 8.3%; P = .008), and SADN >2 mm (69.6% vs 14.3%; P = .001) as well as higher absolute longitudinal strain values in basal and mid segments of the inferior and inferolateral wall than patients with SCA and non-iMVP without other defined structural heart diseases (n = 14). The differences were also observed in comparison to the 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 without other defined structural heart diseases.

Conclusion

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

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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.