Prevalence, clinical significance, and risk factors of arrhythmic mitral valve prolapse - results of the MITPROL AR-PL Registry.
Mitral valve prolapse (MVP) may increase ventricular arrhythmic burden.
To assess prevalence, clinical significance, risk factors of arrhythmic MVP (aMVP) of the Polish MVP population.
454 adult MVP patients were enrolled into MITPROL AR-PL (Mitral Valve Prolapse Polish Registry). Patients with proarrhythmic comorbidities and severe mitral regurgitation were excluded. The study population was divided according to EHRA (European Heart Rhythm Association) 2022 consensus into aMVP, non-arrhythmic MVP (non-aMVP). Demographics, symptoms, electrocardiogram and MVP morphology were analyzed.
The aMVP was diagnosed in 61 (13.5%, mean age 45.0 years, females: 46/75%) and non-aMVP in 215 (47.4%, mean age 47.9 years, females: 157/73%) patients. Differences regarding symptoms were not recorded. Comparison between aMVP and non-aMVP showed a more frequent presence of Barlow's disease (52.5 vs. 25.1%, P < 0.001), bileaflet prolapse (75.4 vs. 47.9%, P < 0.001), Pickelhaube sign (41.0 vs. 21.4%, P = 0.002), mitral annulus disjunction (MAD; 73.8 vs. 48.8%, P < 0.001), inferior leads T-wave inversion (26.2 vs. 13.5%, P = 0.0001) in the aMVP. MAD length (8.4 vs. 8.0 mm, P = 0.04), maximum prolapse depth (5.7 vs. 4.6 mm, P < 0.001), leaflet thickness (5.5 vs. 4.6 mm, P = 0.001) were higher in the aMVP. Multivariable logistic regression showed predictors for aMVP: maximum prolapse depth (OR, 1.21; CI, 1.02-1.45, P = 0.02), leaflet thickness (OR, 1.51, CI, 1.17-1.94, P = 0.001).
The aMVP is rare. Maximum prolapse depth,leaflet thickness are independent aMVP risk factors. Screening for aMVP is reasonable in the MVP population regardless of arrhythmic symptoms with advanced prolapse, without well-recognized proarrhythmic factors.
To assess prevalence, clinical significance, risk factors of arrhythmic MVP (aMVP) of the Polish MVP population.
454 adult MVP patients were enrolled into MITPROL AR-PL (Mitral Valve Prolapse Polish Registry). Patients with proarrhythmic comorbidities and severe mitral regurgitation were excluded. The study population was divided according to EHRA (European Heart Rhythm Association) 2022 consensus into aMVP, non-arrhythmic MVP (non-aMVP). Demographics, symptoms, electrocardiogram and MVP morphology were analyzed.
The aMVP was diagnosed in 61 (13.5%, mean age 45.0 years, females: 46/75%) and non-aMVP in 215 (47.4%, mean age 47.9 years, females: 157/73%) patients. Differences regarding symptoms were not recorded. Comparison between aMVP and non-aMVP showed a more frequent presence of Barlow's disease (52.5 vs. 25.1%, P < 0.001), bileaflet prolapse (75.4 vs. 47.9%, P < 0.001), Pickelhaube sign (41.0 vs. 21.4%, P = 0.002), mitral annulus disjunction (MAD; 73.8 vs. 48.8%, P < 0.001), inferior leads T-wave inversion (26.2 vs. 13.5%, P = 0.0001) in the aMVP. MAD length (8.4 vs. 8.0 mm, P = 0.04), maximum prolapse depth (5.7 vs. 4.6 mm, P < 0.001), leaflet thickness (5.5 vs. 4.6 mm, P = 0.001) were higher in the aMVP. Multivariable logistic regression showed predictors for aMVP: maximum prolapse depth (OR, 1.21; CI, 1.02-1.45, P = 0.02), leaflet thickness (OR, 1.51, CI, 1.17-1.94, P = 0.001).
The aMVP is rare. Maximum prolapse depth,leaflet thickness are independent aMVP risk factors. Screening for aMVP is reasonable in the MVP population regardless of arrhythmic symptoms with advanced prolapse, without well-recognized proarrhythmic factors.
Authors
Mizia-Stec Mizia-Stec, Dziadosz Dziadosz, Danilowicz-Szymanowicz Danilowicz-Szymanowicz, Wejner-Mik Wejner-Mik, Kowalczyk-Domagala Kowalczyk-Domagala, Boruc Boruc, Wierzbowska-Drabik Wierzbowska-Drabik, Staciwa Staciwa, Jaworski Jaworski, Kustrzycka-Kratochwil Kustrzycka-Kratochwil, Uzieblo-Zyczkowska Uzieblo-Zyczkowska, Sorysz Sorysz, Polewczyk Polewczyk, Brzezinska Brzezinska, Kurnicka Kurnicka, Bil Bil, Mozenska Mozenska, Piatkowski Piatkowski, Duchnowski Duchnowski, Golinska-Grzybala Golinska-Grzybala, Kukulski Kukulski, WoĆoszyn-Horak WoĆoszyn-Horak, Kozinski Kozinski, Wachnicka-Truty Wachnicka-Truty, Knapp Knapp, Mickiewicz Mickiewicz, Oko-Sarnowska Oko-Sarnowska, Plewka Plewka, JedliĆski JedliĆski, Kamela Kamela, BaraĆski BaraĆski, Gackowski Gackowski, Szymanski Szymanski, Kasprzak Kasprzak
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