Mitral annular disjunction; how accurate are we? A cardiovascular MRI study defining risk.

Autor:	Hussain N; Allegheny Health Network, Allegheny General Hospital, Center for Cardiovascular MRI, Pittsburgh, PA 15212, USA.; Wilson Medical Center, United Health Service, Johnson City, NY 13790, USA., Bhagia G; Allegheny Health Network, Allegheny General Hospital, Center for Cardiovascular MRI, Pittsburgh, PA 15212, USA.; Benefis Health System, Great Falls, MT 59404, USA., Doyle M; Allegheny Health Network, Allegheny General Hospital, Center for Cardiovascular MRI, Pittsburgh, PA 15212, USA., Rayarao G; Allegheny Health Network, Allegheny General Hospital, Center for Cardiovascular MRI, Pittsburgh, PA 15212, USA., Williams RB; Allegheny Health Network, Allegheny General Hospital, Center for Cardiovascular MRI, Pittsburgh, PA 15212, USA., Biederman RWW; Allegheny Health Network, Allegheny General Hospital, Center for Cardiovascular MRI, Pittsburgh, PA 15212, USA.; West Virginia University, Morgantown, WV 26506, USA.; Medical University of South Carolina, Charleston, SC 29425, USA.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2023 Nov 09; Vol. 49, pp. 101298. Date of Electronic Publication: 2023 Nov 09 (Print Publication: 2023).
DOI:	10.1016/j.ijcha.2023.101298
Abstrakt:	Aims: Mitral Annular Disjunction (MAD) refers to embryologic fibrous separation between mitral annular ring and basal left ventricular myocardium. Since its original description, the role of MAD in arrhythmic mitral valve prolapse (MVP) has been the subject of active research. In this study we sought to assess prognostic and imaging characteristics of MVP patients with and without underlying MAD. Methods and Results: Patients with posterior or bi-leaflet MVP were retrospectively identified via a review of all patients referred to our cardiac magnetic resonance (CMR) imaging laboratory from January 2015 to May 2022. MVP patients were further stratified by underlying MAD status. A total of 100 MVP patients undergoing CMR imaging (52 MVP patients with posterior MAD) were retrospectively identified with female comprising 55 % of the cohort. MVP patients with MAD were more likely to have an abnormal basal inferolateral/ papillary muscles LGE (51 % vs 21 %, p < 0.01). Posterior MAD longitudinal disjunction gap in 'mm' was a predictor of ventricular tachycardia (VT) [1.29, p = 0.01)]. Using ROC curve analysis, a disjunction gap of ≥ 4 mm was predictive of VT (AUC-0.71, p < 0.01), and incorporation of LGE in ROC model further improved AUC to 0.78 confirmed via Akaike information criterion (p < 0.01). Conclusion: Abnormal LGE involving basal inferolateral myocardium and papillary muscles may provide etiologic substrate for arrythmia in MVP patients. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors.)
Databáze:	MEDLINE
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