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Mitral valve prolapse: arrhythmic risk and prognosis
Session:
SESSÃO DE POSTERS 55 - ARRITMOLOGIA: NOVOS DESAFIOS
Speaker:
Mónica Dias
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.2 Valvular Heart Disease – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Mónica Dias; Sofia Fernandes; Diana Fernandes; Inês Conde; Rodrigo Silva; Carla Ferreira; Filipe Vilela; Nuno Salomé; Catarina Vieira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">INTRODUCTION: Mitral valve prolapse (MVP) affects nearly 2 to 3% of the population and is the most common structural heart valve abnormality. It is a mostly benign condition, but there are subgroups of patients with MVP who are at increased risk of malignant ventricular arrhythmias (VA) and ultimately sudden cardiac death (SCD). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">AIM: To characterise a population of patients with MVP and identify factors associated with increased arrhythmic risk. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">METHODS: This was a retrospective observational study including patients with MVP who underwent transthoracic echocardiography (TTE) in our centre between 2014 and 2019, <span style="font-family:"Aptos Display",sans-serif">with a minimum follow-up of 1 year. </span>Patients with left ventricular ejection fraction (LVEF) <span style="font-family:Symbol">£</span>35% and/or other significant structural heart disease were excluded. Patients were divided into three groups according to their arrhythmic risk: low risk (non-complex premature ventricular contractions (PVC), intermediate risk (frequent PVC: ≥5%) and high risk (complex ventricular arrhythmia). The factors associated with arrhythmic risk and predictors of high arrhythmic risk were identified. Multivariate analysis was performed to identify predictors of arrhythmic risk and <span style="font-family:NewsGotT">Kaplan-Meier survival analyses was performed to evaluate differences in mortality among groups. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">RESULTS: 224 patients were included in the study (53.6% male, 66±16.2 years). A total of five patients (4.9%) were included in the high-risk group, 60 patients (58.2%) in the intermediate-risk group, and 38 patients (36.9%) in the low-risk group. Patients with a higher arrhythmic risk were often older (75 vs 64 years, p=0.021) and more frequently exhibited atrial fibrillation (80% vs. 32%, p=0.032), bileaflet MV prolapse (100% vs 47%, p=0.021), flail leaflet (20% vs. 10%, p=0.025), severe left atrial dilatation (50% vs 5%, p=0.005) and severe mitral regurgitation (MR, 100% vs. 38%). On multivariate analysis, predictors of high arrhythmic risk were bileaflet MV prolapse and severe MR. The mortality rate was found to be significantly higher in this group (80% vs 27%, p=0.004), <span style="font-family:"Aptos Display",sans-serif">supported by the Kaplan-Meier curves showing that high arrhythmic risk had significant impact on time to death (p=0.002). </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">CONCLUSION: Arrhythmic risk stratification should be considered in the follow-up and guidance of patients with MVP. Early identification of factors associated with a higher arrhythmic risk other than the severity of mitral valve disease will allow the identification of individuals who will benefit from a more regular clinical and heart rhythm assessment and from particular therapeutic interventions. </span></span></p>
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