Usefulness of cardiac magnetic resonance images for prediction of sudden cardiac arrest in patients with mitral valve prolapse: a multicenter retrospective cohort study

Jae Hyuk Lee, Jae Sun Uhm, Young Joo Suh, Min Kim, In Soo Kim, Moo Nyun Jin, Min Soo Cho, Hee Tae Yu, Tae Hoon Kim, Yoo Jin Hong, Hye Jeong Lee, Chi Young Shim, Young Jin Kim, Jun Kim, Jong Youn Kim, Boyoung Joung, Geu Ru Hong, Hui Nam Pak, Gi Byoung Nam, Kee Joon ChoiYou Ho Kim, Moon Hyoung Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Background: An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients. Methods: MVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed. Results: Of the 85 patients [age, 54.0 (41.0–65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65–148.15; P = 0.004], LGE volume (HR 1.08; 95% CI 1.02–1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08–1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model. Conclusions: The presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.

Original languageEnglish
Article number546
JournalBMC Cardiovascular Disorders
Volume21
Issue number1
DOIs
Publication statusPublished - 2021 Dec

Bibliographical note

Funding Information:
The authors thank Yun-Ho Roh and Won-Jeong Son in the Biostatistics Collaboration Unit, Yonsei University College of Medicine, for their assistance with the statistical analysis. We would like to thank Editage (www.editage.co.kr) for English language editing.

Publisher Copyright:
© 2021, The Author(s).

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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