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Mitral annular disjunction in idiopathic ventricular fibrillation patients: just a bystander or a potential cause?

Title: Mitral annular disjunction in idiopathic ventricular fibrillation patients: just a bystander or a potential cause?
Authors: Verheul, LM; Guglielmo, M; Groeneveld, SA; Kirkels, FP; Scrocco, C; Cramer, MJ; Bootsma, M; Kapel, GFL; Alings, M; Evertz, R; Mulder, BA; Prakken, NHJ; Balt, JC; Volders, PGA; Hirsch, A; Yap, SC; Postema, PG; Nijveldt, R; Velthuis, BK; Behr, ER; Wilde, AAM; Hassink, RJ
Publisher Information: Oxford University Press
Publication Year: 2024
Collection: St George's University of London: Repository
Description: AIMS: Previously, we demonstrated that inferolateral mitral annular disjunction (MAD) is more prevalent in patients with idiopathic ventricular fibrillation (IVF) than in healthy controls. In the present study, we advanced the insights into the prevalence and ventricular arrhythmogenicity by inferolateral MAD in an even larger IVF cohort. METHODS AND RESULTS: This retrospective multi-centre study included 185 IVF patients [median age 39 (27, 52) years, 40% female]. Cardiac magnetic resonance images were analyzed for mitral valve and annular abnormalities and late gadolinium enhancement. Clinical characteristics were compared between patients with and without MAD. MAD in any of the 4 locations was present in 112 (61%) IVF patients and inferolateral MAD was identified in 24 (13%) IVF patients. Mitral valve prolapse (MVP) was found in 13 (7%) IVF patients. MVP was more prevalent in patients with inferolateral MAD compared with patients without inferolateral MAD (42 vs. 2%, P < 0.001). Pro-arrhythmic characteristics in terms of a high burden of premature ventricular complexes (PVCs) and non-sustained ventricular tachycardia (VT) were more prevalent in patients with inferolateral MAD compared to patients without inferolateral MAD (67 vs. 23%, P < 0.001 and 63 vs. 41%, P = 0.046, respectively). Appropriate implantable cardioverter defibrillator therapy during follow-up was comparable for IVF patients with or without inferolateral MAD (13 vs. 18%, P = 0.579). CONCLUSION: A high prevalence of inferolateral MAD and MVP is a consistent finding in this large IVF cohort. The presence of inferolateral MAD is associated with a higher PVC burden and non-sustained VTs. Further research is needed to explain this potential interplay.
Document Type: article in journal/newspaper
File Description: application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document
Language: English
ISSN: 2047-2412
Relation: https://openaccess.sgul.ac.uk/id/eprint/116277/6/jeae054.pdf; https://openaccess.sgul.ac.uk/id/eprint/116277/15/jeae054_supplementary_data.docx; https://openaccess.sgul.ac.uk/id/eprint/116277/1/Manuscript_MADIVF.pdf; Verheul, LM; Guglielmo, M; Groeneveld, SA; Kirkels, FP; Scrocco, C; Cramer, MJ; Bootsma, M; Kapel, GFL; Alings, M; Evertz, R; et al. Verheul, LM; Guglielmo, M; Groeneveld, SA; Kirkels, FP; Scrocco, C; Cramer, MJ; Bootsma, M; Kapel, GFL; Alings, M; Evertz, R; Mulder, BA; Prakken, NHJ; Balt, JC; Volders, PGA; Hirsch, A; Yap, SC; Postema, PG; Nijveldt, R; Velthuis, BK; Behr, ER; Wilde, AAM; Hassink, RJ (2024) Mitral annular disjunction in idiopathic ventricular fibrillation patients: just a bystander or a potential cause? Eur Heart J Cardiovasc Imaging, 25 (6). pp. 764-770. ISSN 2047-2412 https://doi.org/10.1093/ehjci/jeae054 SGUL Authors: Scrocco, Chiara Behr, Elijah Raphael
DOI: 10.1093/ehjci/jeae054
Availability: https://openaccess.sgul.ac.uk/id/eprint/116277/; https://openaccess.sgul.ac.uk/id/eprint/116277/6/jeae054.pdf; https://openaccess.sgul.ac.uk/id/eprint/116277/15/jeae054_supplementary_data.docx; https://openaccess.sgul.ac.uk/id/eprint/116277/1/Manuscript_MADIVF.pdf; https://doi.org/10.1093/ehjci/jeae054
Rights: cc_by_nc_4
Accession Number: edsbas.2AEEA1B5
Database: BASE