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Usefulness of cardiac magnetic resonance images for prediction of sudden cardiac arrest in patients with mitral valve prolapse: a multicenter retrospective cohort study

Authors
 Jae-Hyuk Lee  ;  Jae-Sun Uhm  ;  Young Joo Suh  ;  Min Kim  ;  In-Soo Kim  ;  Moo-Nyun Jin  ;  Min Soo Cho  ;  Hee Tae Yu  ;  Tae-Hoon Kim  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Chi Young Shim  ;  Young Jin Kim  ;  Jun Kim  ;  Jong-Youn Kim  ;  Boyoung Joung  ;  Geu-Ru Hong  ;  Hui-Nam Pak  ;  Gi-Byoung Nam  ;  Kee-Joon Choi  ;  You-Ho Kim  ;  Moon-Hyoung Lee 
Citation
 BMC CARDIOVASCULAR DISORDERS, Vol.21(1) : 546, 2021-11 
Journal Title
BMC CARDIOVASCULAR DISORDERS
Issue Date
2021-11
Keywords
Arrhythmia ; Gadolinium ; Magnetic resonance imaging ; Mitral valve prolapse ; Sudden cardiac death ; Ventricular fibrillation ; Ventricular tachycardia
Abstract
Background: An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients.

Methods: MVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed.

Results: Of the 85 patients [age, 54.0 (41.0-65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65-148.15; P = 0.004], LGE volume (HR 1.08; 95% CI 1.02-1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08-1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model.

Conclusions: The presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.
Files in This Item:
T202105366.pdf Download
DOI
10.1186/s12872-021-02362-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min(김민) ORCID logo https://orcid.org/0000-0002-8132-9873
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Lee, Jae-Hyuk(이재혁) ORCID logo https://orcid.org/0000-0002-1170-7111
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187247
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