Table 1.
Panel A: summary of the studies included. Panel B: summary of the studies included
| Authors | Year | Study design | Inclusion criteria | Exclusion criteria | Control group |
|---|---|---|---|---|---|
| Basso et al | 2015 | Prospective | MVP patients were referred to the cardiology clinic from January 2010 to December 2013 with co-VAs. | Significant MR, tricuspid dysplasia or regurgitation, cardiomyopathies or congenital heart abnormalities, hemodynamically unstable conditions, and contraindications to CMR. | The control group consisted of patients with MVP with minor VA, that is, isolated VPB, couplets, and bigeminal VP. |
| Perazzolo Marra et al | 2016 | Not specified | Consecutive arrhythmic patients (either right bundle branch block or polymorphic VA) were referred to our cardiology clinic from January 2010 to July 2014 with echocardiographic diagnosis of MVP and underwent CE-CMR for the identification of LGE. | Moderate-to-severe MR, tricuspid dysplasia or regurgitation, cardiomyopathies or congenital heart abnormalities, hemodynamically unstable conditions, and contraindications to CE-CMR. | |
| Bui et al | 2017 | Retrospective | The electronic CMR database identified 44 patients with MVP referred for clinical CMR from 2006 to 2011. | Three studies with poor LGE CMR images were excluded. None of the patients with MVP had coronary artery disease, hypertension, or other intrinsic cardiomyopathies. | Consecutively enrolled healthy volunteers free of significant cardiac disease based on clinical and CMR findings. |
| Pradella et al | 2018 | Retrospective | All patients with MVP had undergone a complete CMR between December 2015 and December 2016. | MVP patients with other heart conditions (including other valvular problems). | |
| Enriquez A | 2018 | Retrospective | Patients undergoing catheter ablation of VAs between January 2012 and December 2015 in which one or more clinical PVC morphologies were mapped to the left ventricular (LV) PMs. | Acute ischemia, drug intoxication, electrolyte imbalance, mechanical MV prosthesis, and patients who had no spontaneous or inducible PVCs at the time of the electrophysiology study, precluding activation mapping, were excluded. | |
| Wang TKM et al | 2021 | Retrospective | 21 Patients with MAD and MVP and 21 with MVP without MAD who underwent CMR and TTE within 6 months of each other were identified retrospectively. | Age < 18 years, history of cardiomyopathy, cardiac surgery, heart transplantation, congenital heart disease, and concurrent valve disease of at least moderate severity other than MR. | 21 Controls without MVP or MAD who underwent CMR and TTE within 6 months of each other were identified retrospectively. |
| Constant Dit Beaufils et al | 2021 | Retrospective | Patients with MVP with trace to severe MR enrolled either in an MVP genetic study (genetic and phenotypic characteristics of MVP; NCT03884426) in Nantes (n = 293) or in the MVP STAMP study (stretch and myocardial characterization in arrhythmogenic MVP; NCT02879825) in Nancy, France (n = 152). | Previous cardiac surgery, an implanted device, nonischemic cardiomyopathy, congenital cardiac disease other than isolated bicuspid aortic valve, or more than mild aortic regurgitation or stenosis were not included in the study. Patients with a history of myocardial infarction or symptoms of coronary artery disease, with myocardial infarction-type fibrosis were excluded. Patients with coronary artery disease diagnosed by invasive coronary angiography during the preoperative workup were also excluded. Chronic kidney disease was not an exclusion criterion, but a contrast agent was not used during CMR if the creatinine clearance was < 30 mL/min/1.73 m2. | |
| Pavon et al | 2021 | Retrospective | From the CMR registry of the Lausanne University Hospital, we retrospectively included Patients with a bileaflet MVP and MAD between January 2011 and October 2019. | Patients with myocardial infarction, myocarditis, hypertrophic cardiomyopathy, infiltrative heart disease, more than mild associated VHD, and/or a LVEF < 50% were excluded. | As a control group, we included patients with various degrees of MR identified by echocardiography, who underwent CMR during the same period. |
| Gatti et al | 2021 | Retrospective | Consecutive patients with ages from 18 to 80 years and echocardiographic diagnosis of bMVP. | (i) Tricuspid, pulmonary, and aortic valve diseases; (ii) previous mitral valve surgery or percutaneous treatment; (iii) ischemic heart disease, cardiomyopathies, shunt, pulmonary hypertension, and aortic root dilatation; (iv) atrial fibrillation; (v) ICD or pacemaker; (vi) inability to hold breath or to lay down for 45 min; (vii) claustrophobia; (viii) recent history of alimentary/alcoholic/respiratory intoxication; (ix) estimated glomerular filtration rate < 30 mL min/1.73 m2; (x) history of allergic reaction to MR contrast media; and (xi) pregnancy or breastfeeding. | |
| Lee et al | 2021 | Retrospective | Patients who were diagnosed with MVP on echocardiography, a total of 117 patients (aged ≥ 18 years) patients who underwent CMR for any reason from January 2000 to June 2019 in three university hospitals were retrospectively included. | (1) Presence of concomitant structural heart disease other than MVP; (2) presence of possible causes of SCA other than MVP; (3) CMR performed after mitral valve surgery; and (4) significant (intervention-requiring) coronary artery disease. | |
| Figliozzi et al | 2022 | Retrospective | Aged 18 years or older, MVP was diagnosed at cardiac MRI, clinical information and continuous electrocardiogram monitoring were available within 3 months from cardiac MRI examination, and LGE imaging was available. | Cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse MR (per transthoracic echocardiography report or MR fraction (20% at cardiac MRI), participation in competitive sport, or 12-lead electrocardiogram suggestive of channelopathies. |
| Authors | Arrhythmia evaluation | CMR characteristics evaluated | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Definition of Co-VA | Standard of reference | LV EDVi | LV EF | LA volume | MR severity | PD | MAD | Curling | LGE myocardial | LGE papillary | |
| Basso et al | VF and ventricular tachycardia, either nonsustained or sustained | 12-Lead ECG, 12-lead 24-h Holter monitoring | Yes | No | No | Yes | Yes | No | No | Yes | Yes |
| Perazzolo Marra et al | VF and ventricular tachycardia, either nonsustained or sustained | 12-Lead ECG, 12-lead 24-h Holter monitoring | No | No | No | No | No | No | No | Yes | No |
| Bui et al | Grade III or higher by the Lown and Wolf classification | Holter or event monitor arrhythmia data | Yes | Yes | No | Yes | No | No | No | Yes | No |
| Pradella et al | Grade III or higher by the Lown and Wolf classification | 12-Lead 48- to 72-h ECG Holter monitoring system (Mortara H12) was requested because of the presence of arrhythmic symptoms or 12-lead ECG changes. | No | No | No | No | No | No | No | Yes | No |
| Enriquez A | VF and ventricular tachycardia | Arrhythmia was evaluated during an electrophysiology study with detailed ECG analysis performed offline on the Prucka CardioLab recording system (GE, Houston, TX) with the recordings displayed at a speed of 100 mm/s. | No | No | No | No | No | No | No | No | Yes |
| Wang TKM et al | Ventricular tachycardia and/or VF | VA was defined as documented history in the electronic medical record of testing showing and/or hospitalization for ventricular tachycardia and/or VF. | No | No | No | No | No | Yes | No | No | No |
| Constant Dit Beaufils et al | NSVT and life-threatening ventricular arrhythmia | 24-h ECG recording | No | No | No | No | No | No | No | Yes | No |
| Pavon et al | Grade 4 or 5 according to Lown classification | 24 h Holter monitoring | No | No | No | No | No | No | No | Yes | No |
| Gatti et al | NSVT, SVT, or VF | 12-Lead ECG, as well as 24-h Holter monitoring | Yes | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes |
| Lee et al | VF and sustained or NSVT | 12-Lead ECG | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes |
| Figliozzi et al | VF and ventricular tachycardia, either nonsustained or sustained | At the study outset or with ambulatory electrocardiogram monitoring (24-hour monitoring) or implantable loop recorder within 3 months after cardiac MRI examination. | No | No | No | No | No | Yes | No | Yes | No |
CO-VA complex ventricular arrhythmias, LVEDVi left ventricle end-diastolic volume index, LVEF left ventricle ejection fraction, LA left atrium, MR mitral regurgitation, PD prolapse distance, MAD mitral annular disjunction, LGE late gadolinium enhancement, ECG electrocardiogram, NSVT Non-sustained ventricular tachycardia, VF Ventricular fibrillation, SVT sustained ventricular tachycardia, VA ventricular arrhythmias