Abstract 13313: Ventricular Arrhythmias in Mitral Valve Prolapse: Identification of Clinical and Echocardiographic Associates

• Published in: Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A13313-A13313
• Main Authors: Van Wijngaarden, Aniek L, de Riva Silva, Marta, Hiemstra, Yasmine L, Bax, Jeroen J, Delgado, Victoria, Ajmone Marsan, Nina
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.13313

BackgroundMitral valve prolapse (MVP) is known to be associated with ventricular arrhythmias (VA). However, little is known in these patients about the risk factors for the development of VA, especially in case of significant mitral regurgitation (MR).PurposeOur aim was to describe the prevalence of VA in patients who underwent mitral valve surgery for moderate to severe MR due to MVP and to identify clinical, electrocardiographic (ECG) and echocardiographic parameters associated with VA.Methods797 consecutive patients (65±12 years, 65% male) were included. The presence of VA was defined as symptomatic and frequent premature ventricular contractions (PVCs, Lown grade ≥2), non-sustained ventricular tachycardia (nsVT), VT or ventricular fibrillation (VF) documented before surgery and without an ischemic cause. The echocardiogram and ECG prior to operation were used for analysis. The origin of the PVCs was derived from a 12-lead ECG when available.ResultsA total of 99 (12%) patients showed VA; 70% (69/99) of the patients had PVCs, 36% (36/99) nsVT, 12% (12/99) VT and 3% (3/99) VF. 21 patients had more than one type of VA, of which the combination of PVCs and nsVT was the most common (19/99, 19%). Patients with VA were significantly younger and more frequently diagnosed with Barlow’s disease as compared to patients without VA. Furthermore, patients with VA more often had inferior T-wave inversions and the PVCs predominantly originated from the papillary muscle, whereas in patients without VA the PVCs originated from different regions. Echocardiography showed that patients with VA had a thinner posterior wall, reduced left ventricular ejection fraction and worse global longitudinal strain; more severe MR was not associated with VA (Table).ConclusionPresence of VA in MVP patients undergoing surgery because of significant MR is associated with Barlow’s disease, inferior T-wave inversions, thinner posterior wall and reduced LV systolic function.