Usefulness of cardiac magnetic resonance images for prediction of sudden cardiac arrest in patients with mitral valve prolapse: a multicenter retrospective cohort study

被引：13

作者：

Lee, Jae-Hyuk ^{[1
]}

Uhm, Jae-Sun ^{[1
]}

Suh, Young Joo ^{[2
,3
]}

Kim, Min ^{[1
]}

Kim, In-Soo ^{[1
]}

Jin, Moo-Nyun ^{[1
]}

Cho, Min Soo ^{[4
]}

Yu, Hee Tae ^{[1
]}

Kim, Tae-Hoon ^{[1
]}

Hong, Yoo Jin ^{[2
,3
]}

Lee, Hye-Jeong ^{[2
,3
]}

Shim, Chi Young ^{[1
]}

Kim, Young Jin ^{[2
,3
]}

Kim, Jun ^{[4
]}

Kim, Jong-Youn ^{[5
]}

Joung, Boyoung ^{[1
]}

Hong, Geu-Ru ^{[1
]}

Pak, Hui-Nam ^{[1
]}

Nam, Gi-Byoung ^{[4
]}

Choi, Kee-Joon ^{[4
]}

Kim, You-Ho ^{[4
]}

Lee, Moon-Hyoung ^{[1
]}

机构：

[1] Yonsei Univ, Severance Cardiovasc Hosp, Coll Med, Dept Cardiol, 50-1 Yonsei Ro, Seoul 03722, South Korea

[2] Yonsei Univ, Severance Hosp, Coll Med, Dept Cardiol, Seoul, South Korea

[3] Yonsei Univ, Severance Hosp, Coll Med, Dept Radiol, Seoul, South Korea

[4] Univ Ulsan, Asan Med Ctr, Dept Cardiol, Coll Med, Seoul, South Korea

[5] Yonsei Univ, Gangnam Severance Hosp, Coll Med, Dept Cardiol, Seoul, South Korea

来源：

BMC CARDIOVASCULAR DISORDERS | 2021年 / 21卷 / 01期

关键词：

Arrhythmia; Gadolinium; Magnetic resonance imaging; Mitral valve prolapse; Sudden cardiac death; Ventricular tachycardia; Ventricular fibrillation; LATE GADOLINIUM ENHANCEMENT; VENTRICULAR-TACHYCARDIA; DEATH; CARDIOMYOPATHY; REGURGITATION; DISJUNCTION; PREVALENCE; FIBROSIS; T1;

D O I：

10.1186/s12872-021-02362-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients. Methods MVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed. Results Of the 85 patients [age, 54.0 (41.0-65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65-148.15; P = 0.004], LGE volume (HR 1.08; 95% CI 1.02-1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08-1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model. Conclusions The presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.

引用

页数：10

共 33 条

[1] Mitral valve repair is an effective treatment for ventricular arrhythmias in mitral valve prolapse syndrome [J].