부산대학교 도서관

Introduction: Mitral valve prolapse (MVP) is a common valvular disorder affecting approximately 3% of the population. Several risk factors in patients with MVP for malignant arrythmias, including ventricular tachycardia (VT), fibrillation (VF), and sudden cardiac death (SCD), have been proposed. We performed systematic review and meta-analysis to evaluate risk factors for malignant arrhythmias in patients with MVP.Methods: We comprehensively searched the databases of MEDLINE from inception to May 2022. Included studies were published cohorts comparing patients with MVP and malignant arrhythmias or SCD versus MVP without those events. Data from each study were combined using the random-effects model. Pooled odd ratios (OR) and 95% confidence intervals (CI) were calculated.Results: Five studies from 1985 to 2021 were included involving 769 patients with MVP [100 patients with SCD, VF, VT, and/or implantable cardioverter defibrillator (ICD) shocks]. We found that T-wave inversion (pooled OR=3.14, 95%CI: 2.18-4.5, p<0.001), bileaflet (pooled OR=2.37, 95%CI: 1.39-4.04, p=0.002), late gadolinium enhancement (pooled OR=41.8, 95%CI: 10.7-163, p<0.001), mitral annular disjunction (pooled OR=4.8, 95%CI: 2.7-8.4, p<0.001), redundant leaflets (pooled OR=4.6, 95%CI: 1.02-21.0, p=0.048), and history of syncope (pooled OR=2, 95%CI: 1.002-4.02, p=0.049), were associated with malignant arrythmias and SCD. However, female sex (pooled OR=0.83, 95%CI: 0.26 - 2.65, p=0.748) and moderate-to-severe mitral regurgitation (pooled OR=0.85, 95%CI:0.15-4.91, p=0.853) did not increase the risk.Conclusion: T-wave inversion, mitral annular disjunction, late gadolinium enhancement, history of syncope, redundant leaflets and bileaflet prolapse are associated with an increased risk of malignant arrhythmias and SCD in patients with MVP. Further studies are needed to evaluate the role of electrophysiologic study and ICD in this high-risk population.