Table 2. Summary of studies investigating the high-risk features for sudden cardiac death in mitral valve prolapse patients.
| Author (ref.) | Type of study | No. of patients | Focus of study | Results | SCD Risk profile |
|---|---|---|---|---|---|
| Narayanan et al. (8) | Prospective study | 729 | MVP and SCD | MVP was present in 2.3% of SCD victims | Young age with fewer cardiovascular risk factors |
| Basso et al. (13) | Retrospective study | 650 | MVP and SCD | MVP is an important cause of SCD in young individuals | Female individuals with ventricular arrhythmias of LV origin and frequent repolarization abnormalities in inferior leads, regional LV papillary muscle, and inferobasal fibrosis |
| Sriram et al. (15) | Retrospective study | 1,200 | MVP and SCD | Malignant subset of patients with MVP and life-threatening ventricular arrhythmias | Bileaflet MVP, female sex, and frequent complex ventricular ectopic activity, including premature ventricular contractions of the outflow tract alternating with papillary muscle or fascicular origin |
| Nordhues et al. (18) | Retrospective study | 18,786 | Bileaflet MVP and risk of ventricular dysrhythmias and death | Bileaflet MVP is associated with ventricular tachycardia | Bileaflet MVP in the absence of other risk factors does not seem to portend a poor prognosis |
| Osovska et al. (24) | Prospective study | 145 | Association of heart rhythm disorders in MVP and myxomatous valve degeneration | Significant increase in the total number of both ventricular and supraventricular arrhythmias was observed in all patients with myxomatous degeneration | Myxomatous degeneration is a major risk factor in arrhythmia development |
| Bui et al. (26) | Retrospective study | 72 | Association of diffuse myocardial fibrosis by CMR T1 with complex ventricular arrhythmia in MVP | MVP is associated with diffuse LV myocardial fibrosis | Myocardial fibrosis |
| Perazzolo et al. (28) | Prospective study | 52 | Morphofunctional abnormalities of mitral annulus and arrhythmic MVP | Mitral annulus disjunction is a constant feature of arrhythmic MVP with LV fibrosis. The excessive mobility of the leaflets caused by posterior systolic curling (mechanical stretch of the inferobasal wall and papillary muscles), leads to myocardial hypertrophy and scarring | Mitral annulus abnormalities together with auscultatory midsystolic click |
MVP, mitral valve prolapse; SCD, sudden cardiac death; LV, left ventricular; ECG, electrocardiographic; CMR, cardiovascular magnetic resonance; ref., reference.