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

BMC Cardiovascular Disorders

Jun Kim¹  Kee-Joon Choi¹  You-Ho Kim¹  Gi-Byoung Nam¹  Min Soo Cho¹  Jong-Youn Kim²  Yoo Jin Hong³  Young Joo Suh³  Hye-Jeong Lee³  Young Jin Kim³  Geu-Ru Hong⁴  Chi Young Shim⁴  Jae-Sun Uhm⁴  In-Soo Kim⁴  Tae-Hoon Kim⁴  Moo-Nyun Jin⁴  Boyoung Joung⁴  Moon-Hyoung Lee⁴  Hui-Nam Pak⁴  Hee Tae Yu⁴  Jae-Hyuk Lee⁴  Min Kim⁴ 

[1] Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;Department of Cardiology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea;Departments of Cardiology and Radiology, Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea;Departments of Cardiology, Severance Cardiovascular Hospital, College of Medicine, Yonsei University, 50-1 Yonsei-ro Seodaemun-gu, 03722, Seoul, Republic of Korea;

关键词: Arrhythmia;    Gadolinium;    Magnetic resonance imaging;    Mitral valve prolapse;    Sudden cardiac death;    Ventricular tachycardia;    Ventricular fibrillation;   

DOI  :  10.1186/s12872-021-02362-2

来源: Springer

【 摘 要 】

BackgroundAn 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.MethodsMVP 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.ResultsOf 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.ConclusionsThe 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.

【 授权许可】

CC BY