학술논문
Arrhythmic risk profile in mitral valve prolapse: A systematic review and metanalysis of 1715 patients.
Document Type
Article
Author
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
Source
Subject
*MEDICAL databases
*ECHOCARDIOGRAPHY
*META-analysis
*CONFIDENCE intervals
*VENTRICULAR ejection fraction
*SYSTEMATIC reviews
*MITRAL valve prolapse
*MAGNETIC resonance imaging
*CONTRAST media
*ATRIAL fibrillation
*RISK assessment
*SEX distribution
*VENTRICULAR arrhythmia
*ELECTROCARDIOGRAPHY
*CARDIAC arrest
*DESCRIPTIVE statistics
*MEDLINE
*ODDS ratio
*RESEARCH bias
*MITRAL valve
*DISEASE risk factors
*DISEASE complications
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Language
ISSN
1045-3873
Abstract
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]