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Publications

Journal Article Ahead of print

PubMed: 42484008 DOI: 10.33963/v.phj.113744

Prevalence, clinical significance, and risk factors of arrhythmic mitral valve prolapse - results of the MITPROL AR-PL Registry.

Kardiol Pol

Authors: Katarzyna Mizia-Stec, Dominika Dziadosz, Ludmila Danilowicz-Szymanowicz, Paulina Wejner-Mik, Monika Kowalczyk-Domagala, Agnieszka Boruc, Karina Wierzbowska-Drabik, Mateusz Staciwa, Krzysztof Jaworski, Dorota Kustrzycka-Kratochwil, Beata Uzieblo-Zyczkowska, Danuta Sorysz, Anna Polewczyk, Barbara Brzezinska, Katarzyna Kurnicka, Jacek Bil, Olga Mozenska, Radoslaw Piatkowski, Piotr Duchnowski, Karolina Golinska-Grzybala, Tomasz Kukulski, Ewa Wołoszyn-Horak, Marek Kozinski, Renata Wachnicka-Truty, Malgorzata Knapp, Klaudia Mickiewicz, Zofia Oko-Sarnowska, Michal Plewka, Ireneusz Jedliński, Malgorzata Kamela, Kamil Barański, Andrzej Gackowski, Piotr Szymanski, Jaroslaw D Kasprzak

Affiliations

  • 1st Department of Cardiology, Faculty of Medicine, Centre of European Reference Network of Heart Diseases, Medical University of Silesia, Katowice, Poland.
  • 1st Department of Cardiology, Faculty of Medicine, Centre of European Reference Network of Heart Diseases, Medical University of Silesia, Katowice, Poland.
  • Faculty of Medicine, Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland.
  • 1st Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Łódź, Poland.
  • Pediatric Cardiology Department, The Children's Memorial Health Institute, Warszawa, Poland.
  • Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Łódź, Poland.
  • Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warszawa, Poland.
  • Department of Cardiology, Center for Heart Diseases, 4th Military Clinical Hospital, Wrocław, Poland.
  • Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warszawa, Poland.
  • Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
  • Department of Cardiac Surgery, Swietokrzyskie Cardiology Centre, Kielce, Poland.
  • Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland.
  • Department of Internal Medicine and Cardiology, Infant Jesus Clinical Hospital, Medical University of Warsaw, Warszawa, Poland.
  • JO Medical Center, Warszawa, Poland.
  • 1st Chair and Department of Cardiology, Central Clinical Hospital, Medical University of Warsaw, Warszawa, Poland.
  • Cardinal Wyszynski National Institute of Cardiology, Warszawa, Poland.
  • Noninvasive Cardiovascular Laboratory, Department of Coronary Disease and Heart Failure, John Paul II Hospital, Jagiellonian University Medical College, Kraków, Poland.
  • Second Department of Cardiology, Specialist Hospital in Zabrze, Medical University of Silesia, Zabrze, Poland.
  • Department of Cardiology and Internal Medicine, Medical University of Gdansk, Gdynia, Poland.
  • Department of Cardiology and Internal Disease, Medical University of Bialystok, Białystok, Poland.
  • 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland.
  • Department of Interventional Cardiology and Cardiac Arrhythmias, University Teaching Hospital no. 2 of the Medical University of Lodz, Łódź, Poland.
  • Medicor, Poznań, Poland.
  • Department of Cardiology, Hospital of the Ministry of Interior and Administration, Rzeszów, Poland.
  • Department of Epidemiology, Medical University of Silesia, Katowice, Poland.
  • Center for Clinical Cardiology, Structural and Rare Cardiovascular Diseases, PIM MSWiA, Warszawa, Poland.

Abstract

BACKGROUND

Mitral valve prolapse (MVP) may increase ventricular arrhythmic burden.

AIMS

To assess prevalence, clinical significance, risk factors of arrhythmic MVP (aMVP) of the Polish MVP population.

METHODS

454 adult MVP patients were enrolled into MITPROL AR-PL (Mitral Valve Prolapse Polish Registry). Patients with proarrhythmic comorbidities and severe mitral regurgitation were excluded. The study population was divided according to EHRA (European Heart Rhythm Association) 2022 consensus into aMVP, non-arrhythmic MVP (non-aMVP). Demographics, symptoms, electrocardiogram and MVP morphology were analyzed.

RESULTS

The aMVP was diagnosed in 61 (13.5%, mean age 45.0 years, females: 46/75%) and non-aMVP in 215 (47.4%, mean age 47.9 years, females: 157/73%) patients. Differences regarding symptoms were not recorded. Comparison between aMVP and non-aMVP showed a more frequent presence of Barlow's disease (52.5 vs. 25.1%, P < 0.001), bileaflet prolapse (75.4 vs. 47.9%, P < 0.001), Pickelhaube sign (41.0 vs. 21.4%, P = 0.002), mitral annulus disjunction (MAD; 73.8 vs. 48.8%, P < 0.001), inferior leads T-wave inversion (26.2 vs. 13.5%, P = 0.0001) in the aMVP. MAD length (8.4 vs. 8.0 mm, P = 0.04), maximum prolapse depth (5.7 vs. 4.6 mm, P < 0.001), leaflet thickness (5.5 vs. 4.6 mm, P = 0.001) were higher in the aMVP. Multivariable logistic regression showed predictors for aMVP: maximum prolapse depth (OR, 1.21; CI, 1.02-1.45, P = 0.02), leaflet thickness (OR, 1.51, CI, 1.17-1.94, P = 0.001).

CONCLUSIONS

The aMVP is rare. Maximum prolapse depth,leaflet thickness are independent aMVP risk factors. Screening for aMVP is reasonable in the MVP population regardless of arrhythmic symptoms with advanced prolapse, without well-recognized proarrhythmic factors.

MeSH

Registries, Mitral Valve, Cardiovascular System, Cardiology, Signs And Symptoms, Prevalence, Risk Factors, Mitral Valve Prolapse, Prolapse