Titre
Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Figliozzi, S.
Auteure/Auteur
Georgiopoulos, G.
Auteure/Auteur
Lopes, P.M.
Auteure/Auteur
Bauer, K.B.
Auteure/Auteur
Moura-Ferreira, S.
Auteure/Auteur
Tondi, L.
Auteure/Auteur
Mushtaq, S.
Auteure/Auteur
Censi, S.
Auteure/Auteur
Pavon, A.G.
Auteure/Auteur
Bassi, I.
Auteure/Auteur
Servato, M.L.
Auteure/Auteur
Teske, A.J.
Auteure/Auteur
Biondi, F.
Auteure/Auteur
Filomena, D.
Auteure/Auteur
Pica, S.
Auteure/Auteur
Torlasco, C.
Auteure/Auteur
Muraru, D.
Auteure/Auteur
Monney, P.
Auteure/Auteur
Quattrocchi, G.
Auteure/Auteur
Maestrini, V.
Auteure/Auteur
Agati, L.
Auteure/Auteur
Monti, L.
Auteure/Auteur
Pedrotti, P.
Auteure/Auteur
Vandenberk, B.
Auteure/Auteur
Squeri, A.
Auteure/Auteur
Lombardi, M.
Auteure/Auteur
Ferreira, A.M.
Auteure/Auteur
Schwitter, J.
Auteure/Auteur
Aquaro, G.D.
Auteure/Auteur
Chiribiri, A.
Auteure/Auteur
Rodríguez Palomares, J.F.
Auteure/Auteur
Yilmaz, A.
Auteure/Auteur
Andreini, D.
Auteure/Auteur
Florian, A.
Auteure/Auteur
Leiner, T.
Auteure/Auteur
Abecasis, J.
Auteure/Auteur
Badano, L.P.
Auteure/Auteur
Bogaert, J.
Auteure/Auteur
Masci, P.G.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1527-1315
Statut éditorial
Publié
Date de publication
2023-01
Volume
306
Numéro
1
Première page
112
Dernière page/numéro d’article
121
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
Background Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; P = .03). Conclusion In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gerber in this issue.
PID Serval
serval:BIB_8BFF457C9339
PMID
Date de création
2022-09-20T10:31:09.107Z
Date de création dans IRIS
2025-05-21T01:39:04Z