Transthoracic echocardiography for arrhythmic mitral valve prolapse: Phenotypic characterization as first step.
mitral valve prolapse
transthoracic echocardiography
ventricular arrhythmias
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
09
07
2022
received:
03
05
2022
accepted:
09
08
2022
pubmed:
28
8
2022
medline:
17
9
2022
entrez:
27
8
2022
Statut:
ppublish
Résumé
Mitral valve prolapse (MVP) is the most frequent valvulopathy with a prevalence of 1.2%-2.4% in general population and it is characterized by a benign course. Although it can be associated with some complications, ventricular arrhythmias (VA) and sudden cardiac death (SCD) as ultimate expressions, are the most worrying. The estimated risk of SCD in MVP is between 0.2% and 1.9% per year including both MVP patients with left ventricular (LV) dysfunction due to severe MR and MVP patients without significant MR. The latter ones constitute a particular phenotype called "malignant MVP" characterized by bileaflet myxomatous prolapse, ECG repolarization abnormalities and complex VAs (c-VAs) with polymorphic/right bundle branch block morphology (RBBB) and LV fibrosis of the papillary muscles (PMs) and inferobasal wall secondary to mechanical stretching visualized as late gadolinium enhancement (LGE) areas by cardiac magnetic resonance (CMR). In MVP, the first diagnostic approach is transthoracic echocardiography (TTE) that defines the presence of mitral annular disjunction (MAD) which seems to be associated with "arrhythmic MVP" (AMVP). From an ECG point of view, AMVP is characterized by frequent premature ventricular contractions (PVCs) arising from one or both PMs, fascicular tissue, and outflow tract, as well as by T-wave inversion in the inferolateral leads. The aim of the present paper is to describe TTE red flags that could identify MVP patients at high risk to develop complex arrhythmias as supported by the corresponding findings of LGE-CMR and anatomy studies. TTE could be a co-partner in phenotyping high-risk arrhythmic MVP patients.
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1158-1170Informations de copyright
© 2022 Wiley Periodicals LLC.
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