High-risk phenotypes of arrhythmic mitral valve prolapse : a systematic review and meta-analysis
BACKGROUND: Mitral valve prolapse (MVP) is associated with aggravated risk of ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). There is a lack of specific guideline recommendation regarding risk stratification and management, despite multiple proposed high-risk phenotypes. We performed systematic review and meta-analysis to evaluate high-risk phenotypes for malignant arrhythmias in patients with MVP.
METHODS: We comprehensively searched the databases of MEDLINE, SCOPUS, and EMBASE from inception to April 2023. Included studies were cohort and case-control comparing between MVP patients with and without VT, VF, cardiac arrest, ICD placement, or SCD. Data from each study were combined using the random-effects. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated.
RESULTS: Nine studies from 1985 to 2023 were included involving 2,279 patients with MVP. We found that T-wave inversion (OR 2.52; 95% CI: 1.90-3.33; p < 0.001), bileaflet involvement (OR 2.28; 95% CI: 1.69-3.09; p < 0.001), late gadolinium enhancement (OR 17.05; 95% CI: 3.41-85.22; p < 0.001), mitral annular disjunction (OR 3.71; 95% CI: 1.63-8.41; p < 0.002), and history of syncope (OR 6.96; 95% CI: 1.05-46.01; p = 0.044), but not female (OR 0.96; 95% CI: 0.46-2.01; p = 0.911), redundant leaflets (OR 4.30; 95% CI: 0.81-22.84; p = 0.087), or moderate-to-severe mitral regurgitation (OR 1.24; 95% CI: 0.65-2.37; p = 0.505), were associated with those events.
CONCLUSION: Bileaflet prolapse, T-wave inversion, mitral annular disjunction, late gadolinium enhancement, and history of syncope are high-risk phenotypes among population with MVP. Further research is needed to validate the risk stratification model and justify the role of primary prophylaxis against malignant arrhythmias.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:78 |
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| Enthalten in: |
Acta cardiologica - 78(2023), 9 vom: 15. Nov., Seite 1012-1019 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Benjanuwattra, Juthipong [VerfasserIn] |
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| Links: |
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| Themen: |
Arrhythmia |
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| Anmerkungen: |
Date Revised 24.10.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1080/00015385.2023.2227487 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358596025 |
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| 520 | |a BACKGROUND: Mitral valve prolapse (MVP) is associated with aggravated risk of ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). There is a lack of specific guideline recommendation regarding risk stratification and management, despite multiple proposed high-risk phenotypes. We performed systematic review and meta-analysis to evaluate high-risk phenotypes for malignant arrhythmias in patients with MVP | ||
| 520 | |a METHODS: We comprehensively searched the databases of MEDLINE, SCOPUS, and EMBASE from inception to April 2023. Included studies were cohort and case-control comparing between MVP patients with and without VT, VF, cardiac arrest, ICD placement, or SCD. Data from each study were combined using the random-effects. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated | ||
| 520 | |a RESULTS: Nine studies from 1985 to 2023 were included involving 2,279 patients with MVP. We found that T-wave inversion (OR 2.52; 95% CI: 1.90-3.33; p < 0.001), bileaflet involvement (OR 2.28; 95% CI: 1.69-3.09; p < 0.001), late gadolinium enhancement (OR 17.05; 95% CI: 3.41-85.22; p < 0.001), mitral annular disjunction (OR 3.71; 95% CI: 1.63-8.41; p < 0.002), and history of syncope (OR 6.96; 95% CI: 1.05-46.01; p = 0.044), but not female (OR 0.96; 95% CI: 0.46-2.01; p = 0.911), redundant leaflets (OR 4.30; 95% CI: 0.81-22.84; p = 0.087), or moderate-to-severe mitral regurgitation (OR 1.24; 95% CI: 0.65-2.37; p = 0.505), were associated with those events | ||
| 520 | |a CONCLUSION: Bileaflet prolapse, T-wave inversion, mitral annular disjunction, late gadolinium enhancement, and history of syncope are high-risk phenotypes among population with MVP. Further research is needed to validate the risk stratification model and justify the role of primary prophylaxis against malignant arrhythmias | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Mitral valve prolapse | |
| 650 | 4 | |a arrhythmia | |
| 650 | 4 | |a cardiac arrest | |
| 650 | 4 | |a fibrillation | |
| 650 | 4 | |a sudden cardiac death | |
| 650 | 4 | |a ventricular tachycardia | |
| 700 | 1 | |a Kewcharoen, Jakrin |e verfasserin |4 aut | |
| 700 | 1 | |a Phinyo, Phichayut |e verfasserin |4 aut | |
| 700 | 1 | |a Swusdinaruenart, Sikarin |e verfasserin |4 aut | |
| 700 | 1 | |a Abdelnabi, Mahmoud |e verfasserin |4 aut | |
| 700 | 1 | |a Del Rio-Pertuz, Gaspar |e verfasserin |4 aut | |
| 700 | 1 | |a Leelaviwat, Natnicha |e verfasserin |4 aut | |
| 700 | 1 | |a Navaravong, Leenhapong |e verfasserin |4 aut | |
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