scholarly journals Mitral Valve Prolapse, Arrhythmias, and Sudden Cardiac Death: The Role of Multimodality Imaging to Detect High-Risk Features

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 683
Author(s):  
Anna Giulia Pavon ◽  
Pierre Monney ◽  
Juerg Schwitter
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Multimodality Imaging ◽  
Imaging Evaluation ◽  
Benign Condition ◽  
The 1960S

Mitral valve prolapse (MVP) was first described in the 1960s, and it is usually a benign condition. However, a subtype of patients are known to have a higher incidence of ventricular arrhythmias and sudden cardiac death, the so called “arrhythmic MVP.” In recent years, several studies have been published to identify the most important clinical features to distinguish the benign form from the potentially lethal one in order to personalize patient’s treatment and follow-up. In this review, we specifically focused on red flags for increased arrhythmic risk to whom the cardiologist must be aware of while performing a cardiovascular imaging evaluation in patients with MVP.

scholarly journals Aborted sudden cardiac death due to ventricular fibrillation in a female patient with mitral valve prolapse

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sofien Ayed ◽  
Rainer Hoffmann
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Female Patient ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Secondary Prophylaxis ◽  
Icd Implantation ◽  
Wide Range ◽  
Patients At Risk ◽  
The 1960S

Abstract Background Mitral valve prolapse is the most frequent valvular defect associated with a wide range of electro-hemodynamic abnormalities, leading to heart failure, arrhythmias and sudden cardiac death. Mitral valve prolapse, first described from Barlow in the 1960s, is defined as displacement of mitral leaflet tissue into the left atrium past the mitral annular plane during systole. The correlation between mitral valve prolapse and sudden cardiac death has been investigated and clarified by various studies in recent years. However, identifying patients at risk and applying measures to prevent those from sudden cardiac death is challenging. Case presentation We report on a 61-year-old female patient who had undergone an aborted sudden cardiac death. An arrythmogenic mitral valve prolapse was diagnosed. In addition, electrocardiographically and morphologically risk markers for sudden cardiac death were found in this case. We performed an ICD implantation as secondary prophylaxis and intended to reconstruct the mitral valve. Conclusion This article examines the association of mitral valve prolapse with sudden cardiac death, the underlying pathophysiological mechanisms and the strategies leading to identify the risk group.

scholarly journals Arrhythmic Mitral Valve Prolapse: Introducing an Era of Multimodality Imaging-Based Diagnosis and Risk Stratification

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 467
Author(s):  
Deni Kukavica ◽  
Marco Guglielmo ◽  
Andrea Baggiano ◽  
Giuseppe Muscogiuri ◽  
Laura Fusini ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Multimodality Imaging ◽  
Female Gender ◽  
Imaging Features ◽  
Comprehensive Overview ◽  
Cardiac Condition ◽  
And Function

Mitral valve prolapse is a common cardiac condition, with an estimated prevalence between 1% and 3%. Most patients have a benign course, but ever since its initial description mitral valve prolapse has been associated to sudden cardiac death. Although the causal relationship between mitral valve prolapse and sudden cardiac death has never been clearly demonstrated, different factors have been implicated in arrhythmogenesis in patients with mitral valve prolapse. In this work, we offer a comprehensive overview of the etiology and the genetic background, epidemiology, pathophysiology, and we focus on the state-of-the-art imaging-based diagnosis of mitral valve prolapse. Going beyond the classical, well-described clinical factors, such as young age, female gender and auscultatory findings, we investigate multimodality imaging features, such as alterations of anatomy and function of the mitral valve and its leaflets, the structural and contractile anomalies of the myocardium, all of which have been associated to sudden cardiac death.

scholarly journals Mitral valve and left ventricular features in malignant mitral valve prolapse

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000925 ◽  
Author(s):  
Madalina Garbi ◽  
Patrizio Lancellotti ◽  
Mary N Sheppard
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Abnormal Finding ◽  
Benign Condition ◽  
Artery Disease ◽  
Ventricular Fibrosis ◽  
Death Cases

ObjectiveMitral valve prolapse is a benign condition, however with occasional reports of sudden cardiac death or out-of-hospital cardiac arrest in the absence of severe mitral regurgitation or coronary artery disease, suggesting the existence of a malignant form. The objective of our study was to contribute to the characterisation of malignant mitral valve prolapse.MethodsWe performed a retrospective analysis of pathology findings in 68 consecutive cases of sudden cardiac death with mitral valve prolapse as lone abnormal finding, reported as cause of death.ResultsAll mitral valve prolapse sudden death cases had mitral valve characteristics of Barlow disease, with extensive bileaflet multisegmental prolapse and dilatation of the annulus. The majority of cases (80.9%) had microscopic left ventricular fibrosis with associated hypertrophy and degenerative features of the myocytes, and some cases (10.9%) had right ventricular fibrosis as well.ConclusionsMalignant mitral valve prolapse is Barlow disease. Sudden cardiac death in mitral valve prolapse is due to Barlow disease, which besides the typical mitral valve degeneration may comprise a distinct Barlow disease cardiomyopathy, as suggested by myocyte degeneration and bi-ventricular involvement.

scholarly journals Mechanistic insights of the left ventricle structure and fibrosis in the arrhythmogenic mitral valve prolapse

2018 ◽  
Vol 2018 (1) ◽  
Author(s):  
Leticia Fernández-Friera ◽  
Rafael Salguero ◽  
Luca Vannini ◽  
Ana Fidalgo Argüelles ◽  
Fernando Arribas ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Imaging Techniques ◽  
Current Evidence ◽  
Special Focus ◽  
Benign Condition ◽  
Life Threatening

Mitral valve prolapse (MVP) is a common and benign condition. However, some anatomic forms have been recently associated with life-threatening ventricular arrhythmias and sudden cardiac death. Imaging MVP holds the promise of individualized MVP risk assessment. Noninvasive imaging techniques available today are playing an increasingly important role in the diagnosis, prognosis and monitoring of MVP. In this article, we will review the current evidence on arrhythmogenic MVP, with special focus on the utility of echocardiography and CMR for identifying benign and ‘‘malignant’’ forms of MVP. The clinical relevance of this manuscript lies in the value of imaging technology to improve MVP risk prediction, including those arrhythmic-MVP cases with a higher risk of sudden cardiac death. 

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

scholarly journals SUDDEN CARDIAC DEATH IN MALIGNANT BILEAFLET MITRAL VALVE PROLAPSE

2015 ◽  
Vol 65 (10) ◽  
pp. A751
Author(s):  
Swapna Kanuri ◽  
Pallavi Bellamkonda ◽  
Aryan Mooss
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death

Mitral Valve Prolapse and Athletic Participation in Children and Adolescents

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 789-790
Author(s):  
Keyword(s):  
Mitral Valve ◽  
Children And Adolescents ◽  
Mitral Valve Prolapse ◽  
Holter Monitoring ◽  
Premature Ventricular Contractions ◽  
Benign Condition ◽  
Migraine Headaches ◽  
Asymptomatic Patients ◽  
Vascular Accidents

Mitral valve prolapse (MVP) is generally a benign condition characterized by the protrusion of the mitral valve leaflets into the left atrium during systole. The prevalence of MVP in individuals under the age of 18 years is estimated to be 5% but is higher in those with Marfan's syndrome and other collagen vascular disorders.1 A midsystolic nonejection click with or without a late systolic murmur is the auscultatory hallmark of this syndrome. The diagnosis of MVP in children and adolescents should be based primarily on auscultatory findings and not on minor echocardiographic findings.1 The prognosis in children and adolescents with isolated MVP appears to be excellent and complications are rare. In 553 children, aged 15 days to 18 years, who were involved in studies with a follow-up period of 6 to 9 years, the following were reported: subacute bacterial endocarditis (one case), cerebral vascular accidents (two cases), migraine headaches (four cases), and chest pain (12 cases).2,3 Only four cases of sudden death have been reported in patients younger than 20 years of age.1-4 In a study of 103 patients with MVP, 16% were found to have premature ventricular beats during exercise electrocardiography (ECG) (exercise test).3 Thirty-eight percent were found to have premature ventricular contractions (PVCs) on 24-hour ECG (Holter) monitoring. This study, however, does not report the true prevalence of dysrhythmias because all these subjects had been referred to a pediatric cardiologist for evaluation. It is likely that these reported numbers are high because asymptomatic patients are less often referred.

scholarly journals 1045 T1-mapping and CMR feature tracking in mitral valve prolapse

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Guglielmo ◽  
L Fusini ◽  
G Muscogiuri ◽  
A Baggiano ◽  
A Loffreno ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Prolapse ◽  
Cardiac Death ◽  
Feature Tracking ◽  
T1 Mapping ◽  
Remote Myocardium ◽  
Severe Mitral Regurgitation ◽  
T1 Map

Abstract BACKGROUND Several studies suggest that mitral valve prolapse (MVP) can be related to sudden cardiac death, owing to sustained ventricular arrhythmias (VAs). In patients with sudden cardiac death and complex VAs, a high percentage of either left ventricle (LV) papillary muscle fibrosis or inferobasal fibrosis has been described using cardiac magnetic resonance (CMR) with late gadolinium enhancement technique (LGE). However, LGE presents several technical limitations and requires contrast agent administration. Thanks to T1 mapping (T1-map) and feature tracking (FT) techniques, CMR may identify myocardial fibrosis and deformation abnormalities respectively. We sought to demonstrate that, in patients with MVP, T1 map can accurately identify the presence of myocardial fibrosis which, being related to myocardial stiffness, is associated to abnormal deformation indexes at CMR FT strain evaluation. METHODS Consecutive patientswith indication to mitral valve surgery for severe mitral regurgitation due to mitral valve prolapse were prospectively enrolled. CMR including Modified Look-Locker (MOLLI) sequences for T1 mapping was performed in each patient. In addition, CMR FT analysis of steady state free precession (SSFP) cine images was performed to obtain 2D global and segmental circumferential and radial strains. RESULTS 70 consecutive patients (age: 59 ± 12) were successfully evaluated with CMR. T1 native values were significantly higher in the basal and mid LV inferolateral wall compared to the remote myocardium (1074 ± 67 vs 1046 ± 40 msec, p&lt; 0.001). Moreover, the average radial and circumferential strains of the basal and mid LV inferolateral were significantly reduced compared to those of the remote myocardium (21.1 ± 10.4 and -12.8 ± 5.6 vs 31.6 ± 9.1 and -17.3 ± 3.6 respectively, p &lt; 0.001). CONCLUSIONS In patients with MVP and severe mitral regurgitation native T1 values of the LV inferolateral are higher as compared to remote myocardium and associated with reduced circumferential and radial strains. T1 mapping and CMR FT strain may be used as tools for the early identification of tissue changes in the LV inferolateral myocardial segment. Further studies are needed to evaluate if these changes are able to predict LGE development and are associated with higher risk for VAs

Identification of a high-risk subgroup with malignant mitral valve prolapse who are predisposed to sudden cardiac death. A Review

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ronald Russo ◽  
Abhishek Maan ◽  
Eirini Apostolidou ◽  
Arshia Khorasani-zadeh ◽  
Sean Byrnes ◽  
...  
Keyword(s):  
High Risk ◽  
Sudden Cardiac Death ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cardiac Death
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