Citations 2
Incidence and type of recurrent ventricular arrhythmia in patients with arrhythmic mitral valve prolapse and implantable cardioverter defibrillator for secondary prevention
Kneizeh, Kinan , Sacher, F, Notaristefano, Francesco , Vlachos, Konstantinos , Ditac, Geoffroy , Duchâteau, Josselin , Munoz, Freddy Del‐Carpio , Jaworski, K, Alqarawi, Wael, Vandenberk, Bert , Verheul, Lisa M , Hassnik, Rutger J , Deville, Lucas, Yvorel, Cédric , Boukhris, Marouane , Pierrard, Romain, Ploux, Sylvain , Witte, K K, Costa, A Da, Bénali, Karim , Sacher, Frederic , Del-Carpio Munoz, Freddy , Jaworski, Krysztof , Figliozzi, Stefano , Verheul, Lisa M , Hassnik, Rutger J , Deville, Lucas , Yvorel, Cedric , Boukhris, Marouane , Pierrard, Romain , Ploux, Sylvain , Jaïs, Pierre , Hocini, Mélèze , Frontera, Antonio , Witte, Klaus K , Pürerfellner, Helmut , Haissaguerre, Michel , Da Costa, Antoine , Benali, Karim , Kneizeh, Kinan , Sacher, Frédéric , Duchâteau, Josselin , Alqarawi, Wael , Vandenberk, Bert , Jaı̈s, Pierre
Europace | May 3, 2026 | Volume: 28 | Issue: 6 | Pages: No page available
Abstract Aims Mitral valve prolapse (MVP) is a common valvular disorder associated with ventricular arrhythmias (VAs) in a subgroup of patients, known as arrhythmic MVP (AMVP). Arrhythmic MVP patients with malignant VAs typically receive an implantable cardioverter-defibrillator (ICD) for secondary prevention. However, data regarding the incidence of appropriate ICD therapy and the type of arrhythmia recurrence in this population remain scarce. This study aimed to evaluate the incidence of appropriate ICD therapies and type of arrhythmia recurrence in AMVP patients with an ICD implanted for secondary prevention. Methods and results A systematic literature search was conducted in PubMed/MEDLINE and EMBASE databases until January 2025. Studies reporting the incidence of appropriate ICD therapy in AMVP patients were included. A total of 9 studies met the inclusion criteria, resulting in 166 AMVP patients with ICDs for secondary prevention. The mean age was 41.8 years, with 55.8% of patients being female. Over a weighted mean follow-up of 4.9 ± 3.1 years, 34.9% [95% confidence interval (CI): 28.1–42.5] of the patients experienced recurrence of VA. The pooled incidence of appropriate ICD therapies during follow-up was 8.1 per 100 person-years (95% CI: 5.6–10.5, I2: 11.7%). Regarding the type of arrhythmic recurrence, the majority of arrhythmias (53.8%, 95% CI: 44.3–63.0%) were in the form of ventricular fibrillation or polymorphic ventricular tachycardia (VT), while the remaining arrhythmias were reported as monomorphic VT. Among 67 ventricular arrhythmic episodes reported in 7 studies with available data, 65 required shock therapy, corresponding to a shock proportion of 97.0% (95% CI: 89.6–99.6%). Conclusion Arrhythmic MVP patients with ICDs for secondary prevention exhibit a high risk of recurrent arrhythmias, with recurrences in the form of polymorphic VA occurring in more than half of the cases. PROSPERO registration number: CRD42024588610
Mitral valve prolapse and cardiac chamber remodelling: a propensity-score-matched CMR study
Donia, Dario , Schwitter, Janine, Rodriguez-Palomares, J F, Andreini, D, Leiner, Tim, Pontone, G, Francone, M, Abecasis, J, Bogaert, J, Georgiopoulos, G, Masci, P G, Figliozzi, Stefano , Stankowski, Kamil , Tondi, Lara , Censi, Stefano , Rodríguez-Palomares, José Fernando , Andreini, Daniele , Leiner, Tim , Pontone, Gianluca , Francone, Marco , Abecasis, João , Bogaert, Jan , Georgiopoulos, Georgios A. , Masci, Pier Giorgio
European Heart Journal - Cardiovascular Imaging | January 30, 2026 | Volume: 27 | Issue: Supplement_1 | Pages: No page available
Abstract Background Mitral valve prolapse (MVP) is the most common valvular abnormality in the population. Emerging evidence suggests that MVP is associated with left ventricular (LV) remodelling and dysfunction regardless of mitral regurgitation (MR) severity mimicking an early stage of dilated cardiomyopathy. However, prior studies have provided scattered results and were limited by small sample size and poor adjustment for confounders. Purpose To assess early cardiac chamber remodelling associated with MVP in absence of significant MR. Methods This multicentre, retrospective case-control study included patients with isolated MVP without significant MR undergoing CMR including late gadolinium enhancement (LGE). Healthy controls (HC) were selected from local databases and included subjects without cardiovascular pathology or significant comorbidities, with normal CMR parameters defined as comprised within normality ranges reported in the literature. Propensity-score-matching (PSM) was performed in a 1:1 nearest neighbour without replacement method (calliper 0.1), based on age, sex, body-surface-area, hypertension, and diabetes. The impact of MVP on cardiac remodelling was quantified using absolute standardized mean differences (SMDs). Results A total of 587 MVP patients and 583 HC were included, with 517 pairs successfully matched after PSM. Compared to HC, MVP patients showed greater left atrial (LA) area (12.2 [10.5 – 14.1] vs. 11.0 [9.5 – 12.4] cm²/m²), left ventricular (LV) end-diastolic-volume (86.3 [72.4–101.4] vs. 76.3 [66.1–86.0] ml/m²), and lower LV ejection-fraction (60.0% [55.2–65.6] vs. 61.0% [58.0–66.0], all p<0.001). MVP patients also showed greater right atrial area, right ventricular end-diastolic-volume, and higher right ventricular ejection-fraction compared to HC (Figure 1). The greatest impact of MVP on remodelling was observed for LV-end-diastolic volume and left atrial size (SMD ~0.55–0.62, respectively), (Figure 2). Among patients with MVP, remodelling was most pronounced in patients with bi-leaflet MVP and LGE. Conclusions In the absence of significant MR, MVP is associated with cardiac chambers’ remodelling with a particular emphasis on LV and LA dilatation.Cardiac chamber parameters in HC vs. MVP Effect size of MVP on cardiac remodeling