Anterior Mitral Valve Length is Associated with Ventricular Tachycardia in Patients with Classical Mitral Valve Prolapse

Methods: Thirty patients (nine men and 21 women; mean age, 41.5 +/- 15 years) in sinus rhythm with mitral valve prolapse who had VT in 24-hour Holter analysis and 30 patients with MVP without VT (eight men and 22 women; mean age, 43 +/- 16 years) were included in this study. Transthoracic echocardiography, QT analyses from 12-lead electrocardiography, and 24-hour Holter electrocardiogram recordings were performed. Results: Mitral posterior leaflet thickness (0.48 +/- 0.03 cm vs 0.43 +/- 0,08 cm, P = 0.025), mitral anterior leaflet length (3.2 +/- 0.24 cm vs 2.9 +/- 0.36, P < 0.001), mitral posterior leaflet length (2.2 +/- 0.3 cm vs 1.9 +/- 0.35 cm, P = 0.01), left atrium anteroposterior diameter (4.2 +/- 0.8 cm vs 3.5 +/- 0.5 cm, P = 0.001), and mitral annulus circumference (15.7 +/- 1.3 cm vs 14.6 +/- 1.6 cm, P = 0.004) were increased significantly in MVP cases with VT. No significant difference was found between the cases with and without VT in terms of frequency- and time-domain analysis. QT dispersion (72 +/- 18 ms vs 55 +/- 15 ms, P = 0.0002) and corrected QT dispersion (QTcD) (76 +/- 18 ms vs 55 +/- 15 ms, P = 0.0002) were significantly increased in cases with VT compared with those without VT. Based on logistic regression analysis for MVP cases, in the case of VT, an enhancement in QTcD (P = 0.01) and the mitral anterior leaflet length (P = 0.003) were the independent predictors of VT. Conclusion: Mitral anterior leaflet length and enhanced QTcD are closely related with VT in patients with classical MVP. (PACE 2010; 33:1224-1230).