Arrhythmic risk profile in mitral valve prolapse: A systematic review and metanalysis of 1715 patients.

Autor:	Pistelli, Lorenzo, Vetta, Giampaolo, Parlavecchio, Antonio, Crea, Pasquale, Parisi, Francesca, Magnocavallo, Michele, Caminiti, Rodolfo, Frea, Simone, Vairo, Alessandro, Desalvo, Paolo, Faletti, Riccardo, Gatti, Marco, Dattilo, Giuseppe, Parollo, Matteo, Di Cori, Andrea, Bongiorni, Maria Grazia, De Santis, Giulia, Borgi, Marco, Franzino, Marco, Licordari, Roberto
Předmět:	RISK assessment VENTRICULAR ejection fraction MITRAL valve SEX distribution MITRAL valve prolapse META-analysis MAGNETIC resonance imaging DESCRIPTIVE statistics SYSTEMATIC reviews MEDLINE ODDS ratio ELECTROCARDIOGRAPHY VENTRICULAR arrhythmia MEDICAL databases ATRIAL fibrillation CONFIDENCE intervals CARDIAC arrest ECHOCARDIOGRAPHY DISEASE risk factors DISEASE complications
Zdroj:	Journal of Cardiovascular Electrophysiology; Feb2024, Vol. 35 Issue 2, p290-300, 11p
Abstrakt:	Introduction: Mitral valve prolapse (MVP) is a common clinical condition in the general population. A subgroup of patients with MVP may experience ventricular arrhythmias and sudden cardiac death ("arrhythmic mitral valve prolapse" [AMVP]) but how to stratify arrhythmic risk is still unclear. Our meta‐analysis aims to identify predictive factors for arrhythmic risk in patients with MVP. Methods: We systematically searched Medline, Cochrane, Journals@Ovid, Scopus electronic databases for studies published up to December 28, 2022 and comparing AMVP and nonarrhythmic mitral valve prolapse (NAMVP) for what concerns history, electrocardiographic, echocardiographic and cardiac magnetic resonance features. The effect size was estimated using a random‐effect model as odds ratio (OR) and mean difference (MD). Results: A total of 10 studies enrolling 1715 patients were included. Late gadolinium enhancement (LGE) (OR: 16.67; p =.005), T‐wave inversion (TWI) (OR: 2.63; p <.0001), bileaflet MVP (OR: 1.92; p <.0001) and mitral anulus disjunction (MAD) (OR: 2.60; p <.0001) were more represented among patients with AMVP than in NAMVP. Patients with AMVP were shown to have longer anterior mitral leaflet (AML) (MD: 2.63 mm; p <.0001), posterior mitral leaflet (MD: 2.96 mm; p <.0001), thicker AML (MD: 0.49 mm; p <.0001), longer MAD length (MD: 1.24 mm; p <.0001) and higher amount of LGE (MD: 1.41%; p <.0001) than NAMVP. AMVP showed increased mechanical dispersion (MD: 8.04 ms; 95% confidence interval: 5.13–10.96; p <.0001) compared with NAMVP. Conclusions: Our meta‐analysis proved that LGE, TWI, bileaflet MVP, and MAD are predictive factors for arrhythmic risk in MVP patients. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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