| Autor: |
Burke, Allen P., Farb, Andrew, Tang, Anita L., Rabin, Ira, Virmani, Renu |
| Zdroj: |
Journal of the American College of Cardiology; February 1995, Vol. 25 Issue: 2, Number 2 Supplement 1 p167A-167A, 1p |
| Abstrakt: |
Patients with isolated mitral valve prolapse (MVP) without significant mitral regurgitation are at a slightly increased risk of sudden cardiac death compared to the normal population. The mechanism(s) of sudden cardiac death in isolated MVP are uncertain. We studied gross hearts and histologic sections of the atrioventricular (AV) node in 21 patients with isolated MVP dying suddenly without apparent cause other than MVP (Group 1, mean age 36±8 years, mean heart weight 420±89 grams). No patient in Group 1 had a history of or treatment for mitral regurgitation, and no left atrial dilatation was present at autopsy. Sudden cardiac death MVP cases were compared to 15 control hearts from trauma victims without cardiac disease (Group 2, mean age 30±7 years, mean heart weight 350±96 grams). Sections of the artery to the AV node within the atrial septum (mean 7 levels in each group) were stained for elastic tissue and proteoglycans. Dysplasia was defined as focal deposition of proteoglycans within the media and partial disruption of the internal elastic lamina. The ratio of lumen area to arterial area was determined by computerized planimetry at the level of greatest luminal narrowing and measured (mean±SEM) 0.33±0.04 for Group 1 and 0.52±0.04 for Group 2 (p=0.001) this ratio was independent of heart weight, age, or sex of patient by stepwise regression. Dysplasia of the AV nodal artery was present in 9/21 (43%) hearts in Group 1 versus 1/15 (7%) hearts in group 2 (p<0.02) We conclude that narrowing of the AV nodal artery and arterial dysplasia are more prevalent in patients with MVP and sudden cardiac death than controls and may represent a more generalized disorder of proteoglycan deposition. The relationship between these findings and sudden cardiac death needs to be further studied. |
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