CORRELATION BETWEEN CLINICAL AND ECHOCARDIOGRAPHIC FINDINGS WITH THE OCCURRENCE OF VENTRICULAR ARRHYTHMIAS IN PATIENTS WITH MITRAL VALVE PROLAPSE
Background: Chronic Mitral valve prolapse (MVP) has been linked to the
occurrence of serious ventricular arrhythmias and sudden cardiac death.
However, their mechanism is not fully understood particularly in the
absence of haemodynamically significant mitral regurgitation (MR).
Objectives: The aim of the study is to identify if there are specific clinical
and echocardiographic criteria that can predict the occurrence of
ventricular arrhythmias in patients with mitral valve prolapse.
Methods:We prospectively enrolled 30 consecutive patients with MVP.
Clinical examination, echocardiography (standard and speckle tracking)
and 24 hours Holter monitoring were performed in all patients. The
patients were further divided into 2 groups: arrhythmic MVP (7 patients)
and non- arrhythmic MVP (23 patients) based on the presence of complex
ventricular arrhythmias on Holter monitoring.
Results: Patients with arrhythmic MVP experienced syncope more
frequently compared to the non- arrhythmia group (57 vs 4%, p=0.006).
They also had larger left ventricular (LV) end systolic volume (45 ± 8.8 vs
36 ± 8 ml, p=0.023) despite similar LV ejection fraction (EF) and global
longitudinal strain (GLS). The arrhythmic MVP patients had wider mitral
annular disjunction (7.7 ± 3.8 vs 3.9 ± 3.9 mm, p=0.033).There were no
significant difference between the 2 groups regarding the degree of mitral
regurgitation, leaflet affection (single or bileaflet) or mitral annular
Conclusion:Increased left ventricular end systolic volume and the degree
of annular disjunction by echocardiography may contribute to the
arrhythmic risk in patients with MVP irrespective of the presence and
severity of mitral regurgitation.