Table 1.
Patient characteristics
| n (%)/median (IQR) | All patients (N = 62) | m-VA (n = 26) | c-VA (n = 36) | P value |
|---|---|---|---|---|
| Demographics and comorbidities | ||||
| Age, y | 59.5 (51-65) | 63.5 (56-67) | 55 (49.5-62.5) | .029 |
| Age at MR/MVP diagnosis, y | 42.4 (27.5-53) | 50.5 (31-58) | 41.2 (23-51) | .098 |
| Age at VA diagnosis, y | 50.8 (38-58.4) | 57.4 (47.5-63.7) | 46.7 (37.8-54.9) | .007 |
| Symptoms functional class | .145 | |||
| NYHA I | 29 (46.8) | 15 (57.7) | 14 (38.9) | |
| NYHA II | 28 (45.2) | 8 (30.8) | 20 (55.6) | |
| NYHA III | 5 (8.1) | 3 (11.5) | 2 (5.6) | |
| Female | 26 (41.9) | 10 (38.5) | 16 (44.4) | .64 |
| Familial MVP | 17 (27.4) | 5 (19.2) | 12 (33.3) | .223 |
| Hypertension | 28 (45.2) | 11 (42.3) | 17 (47.2) | .704 |
| Diabetes mellitus | 2 (3.2) | 1 (3.8) | 1 (2.8) | .816 |
| Chronic lung disease | 3 (4.8) | 2 (7.7) | 1 (2.8) | .377 |
| Smoking | 15 (24.2) | 7 (26.9) | 8 (22.2) | .902 |
| Obstructive sleep apnea | 3 (4.8) | 0 (0) | 3 (8.3) | .134 |
| Secondary PHT | 22 (35.5) | 10 (38.5) | 12 (33.3) | .679 |
| Atrial fibrillation/flutter | 13 (21) | 3 (11.5) | 10 (27.8) | .124 |
| BP systolic, mm Hg | 130 (118-137) | 130 (120-142) | 127 (112.5-132.5) | .157 |
| BP diastolic, mm Hg | 73.9 (68-81) | 78.5 (68-83) | 74 (68-80) | .461 |
| Pulse Pressure, mm Hg | 53 (44-63) | 58 (50-64) | 50 (44-60) | .139 |
| Antiarrhythmic therapy | 23 (37.1) | 7 (26.9) | 16 (44.4) | .162 |
| Diuretic therapy | 7 (11.3) | 3 (11.5) | 4 (11.1) | .958 |
| Serum K+, mEq/L | 4.2 (4.1-4.4) | 4.2 (4-4.4) | 4.3 (4.1-4.5) | .271 |
| BNP, pg/mL | 59 (26.9-108.2) | 57.6 (23.8-123) | 59 (29.8-105) | .825 |
| Multimodality imaging | ||||
| Resting echocardiography | 62 (100) | 26 (100) | 36 (100) | – |
| LV EF, % | 63 (59-65) | 64 (60-68) | 62 (57.8-65) | .167 |
| LVEDDi, cm/m2 | 2.92 (2.7-3.2) | 2.87 (2.6-3.1) | 2.95 (2.67-3.2) | .617 |
| LVESDi, cm/m2 | 1.87 (1.67-2) | 1.85 (1.7-2.06) | 1.87 (1.66-2.05) | .96 |
| LV mass(i), g/m2 (range) | 117.5 (100-131.6) | 118.6 (97.7-131.7) | 116.9 (102.4-131.4) | .765 |
| LV wall stress (×10³), dyn/cm2 | 69.7 (51.2-83.3) | 74.6 (56.5-81.2) | 67.6 (48.4-88.3) | .485 |
| Peak GLS, % | −25.5 (−27 to −23.5) | −25.9 (−26.8 to −24.3) | −25 (−27.3 to −23.1) | .315 |
| LV mechanical dispersion, ms | 50 (33.7-80.2) | 40.9 (30.7-81) | 52.2 (36.9-78.7) | .253 |
| LAVi, mL/m2 | 61.7 (54.2-89.6) | 67.6 (54.3-91.4) | 60.4 (54-83) | .406 |
| PASP, mm Hg | 28 (24-40) | 27.3 (25-43) | 28 (23.4-40) | .196 |
| MV E/A | 1.5 (1.13-1.77) | 1.43 (1.15-1.66) | 1.47 (1.13-1.87) | .523 |
| MV E/e' | 9.9 (7.3-12.9) | 10.1 (8.9-14.1) | 8.8 (7.3-12.5) | .28 |
| Diastolic filling time, ms | 512 (423-602) | 488.7 (400.3-572.5) | 513.5 (433-624) | .330 |
| Bileaflet prolapse | 40 (64.5) | 13 (50) | 27 (75) | .04 |
| Bileaflet prolapse—female patients | 20 (32.3) | 5 (19.2) | 15 (41.7) | .064 |
| Cardiac MRI | 36 (58.1) | 13 (50) | 23 (63.9) | .278 |
| LV scar/fibrosis (LGE+) | 24 (68.6) | 9 (69.2) | 15 (68.2) | .739 |
| Preoperative hybrid PET/MRI | 22 (35.5) | 10 (38.5) | 12 (33.3) | .679 |
| LV inflammation (FDG+) | 19 (86.4) | 7 (70) | 12 (100) | .046 |
| Coronary anatomy | .168 | |||
| Normal coronaries | 44 (71) | 16 (61.5) | 28 (77.8) | |
| Nonobstructive CAD | 18 (29) | 10 (38.5) | 8 (22.2) | |
| Baseline ventricular arrhythmia profile, complexity, and ECG characteristics | ||||
| MR diagnosis to VA, y | 9 (4.4-22); (n = 45) | 8 (3-20); (n = 22) | 13 (6-27); (n = 23) | .146 |
| VA diagnosis to MR, y | 2 (1.9-3.5); (n = 17) | 2.5 (1.9-3); (n = 4) | 2 (1.8-6); (n = 13) | .817 |
| Ambulatory rhythm monitor | 48 (77.4) | 13 (50) | 35 (97.2) | <.0001 |
| VA burden, % (range) | 0.97 (0.01-47) | 0.2 (0.01-10) | 1.53 (0.1-47) | .006 |
| Bigeminy | 24 (39.3) | 2 (7.7) | 22 (62.9) | – |
| Pleiomorphic PVCs | 21 (33.9) | 21 (58.3) | ||
| Ventricular couplets | 26 (41.9) | 26 (72.2) | ||
| Ventricular tachycardia | 30 (48.4) | 30 (83.3) | ||
| VA-related syncope | 10 (16.1) | 10 (27.8) | – | |
| Sudden cardiac arrest | 4 (6.5) | 4 (11.1) | – | |
| ICD | 8 (12.9) | 8 (22.2) | – | |
| Heart rate, beats/min | 66.5 (59-79) | 68.5 (63-80) | 65 (58.5-74) | .288 |
| Sinus bradycardia | 16 (25.8) | 5 (19.2) | 11 (30.6) | .318 |
| QTc, ms | 434.5 (420-446) | 434.5 (421-453) | 434.5 (420-446) | .643 |
| QTc (age-adj), ms | 433.4 (431-435) | 434.6 (432.4-435.6) | 432.1 (430.5-434.3) | .029 |
| Prolonged QTc | 22 (35.5) | 11 (42.3) | 11 (30.6) | .343 |
| Prolonged QTc, ms | 451.5 (446-457) | 454 (442.8-466.3) | 448 (446.3-455.8) | .645 |
| Prolonged QTc (age-adj), ms | 434.1 (432.7-434.7) | 434.7 (434.1-435.7) | 433.6 (428.9-434.4) | .012 |
| QRS, ms (range) | 97 (88-104) | 98 (90-102) | 95 (86-104) | .943 |
| Nonspecific ST-T | 15 (24.2) | 7 (26.9) | 8 (22.2) | .672 |
| Repolarization abnormalities | 9 (14.5) | 4 (15.4) | 5 (13.9) | .870 |
| Inverted/biphasic T-waves | 31 (50) | 13 (50) | 18 (50) | – |
| Infarct pattern | 23 (37.1) | 8 (30.8) | 15 (41.7) | .385 |
| T-wave inversion—inferior | 7 (30.4) | 1 (12.5) | 6 (40) | .182 |
| T-wave inversion—anterior | 16 (69.6) | 7 (87.5) | 9 (60) | |
| Conduction delay | 21 (33.9) | 5 (19.2) | 16 (44.4) | .040 |
| 1° AV block | 8 (12.9) | 2 (7.7) | 6 (16.7) | .302 |
| Fascicular block | 13 (21) | 3 (11.5) | 10 (27.8) | .124 |
| LBBB | 1 (7.7) | 1 (33.3) | – | .067 |
| RBBB | 12 (92.3) | 2 (66.7) | 10 (100) | |
| LVH-ECG voltage criteria | 17 (27.4) | 6 (23.1) | 11 (30.6) | .518 |
IQR, Interquartile range; m-VA, minor ventricular arrhythmia; c-VA, complex ventricular arrhythmia; MR, mitral regurgitation; MVP, mitral valve prolapse; VA, ventricular arrhythmia; NYHA, New York Heart Association; PHT, pulmonary hypertension; BP, blood pressure; BNP, brain natriuretic peptide; LV, left ventricle/-cular; EF, ejection fraction; EDDi, end-diastolic diameter index; ESDi, end-systolic diameter index; GLS, global longitudinal strain; LAVi, left atrial volume index; PASP, pulmonary arterial systolic pressure; MV, mitral valve; MRI, magnetic resonance imaging; LGE, late gadolinium enhancement; PET, positron emission tomography; FDG, fluorodeoxyglucose; CAD, coronary artery disease; ECG, electrocardiogram; MR, mitral regurgitation; PVC, premature ventricular contraction; ICD, implantable cardioverter/defibrillator; AV, atrioventricular; LBBB, left bundle branch block; RBBB, right bundle branch block; LVH, left ventricular hypertrophy.