Skip to main content
SpringerLink
Log in

Predictors of ventricular arrhythmias in patients with mitral valve prolapse

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Arrhythmias have been reported to occur frequently in symptomatic patients with mitral valve prolapse (MVP). The mechanisms causing ventricular arrhythmias in patients with MVP have not been fully investigated. The purpose of this study was to determine the clinical, echocardiographic and heart rate variability parameters, and plasma concentrations of electrolytes and inflammatory markers in predicting ventricular arrhythmias in patients with MVP. A total of 58 consecutive patients with MVP were included in this study. We performed electrocardiography, echocardiography, holter analysis, routine biochemical tests including plasma concentrations of electrolytes and inflammatory markers, and evaluated the clinical characteristics. Ventricular arrhythmia defined as occurrence of any of the followings: ventricular premature contractions (VPCs), VPC couplets, and ventricular tachycardia documented by holter analysis, continuous monitoring or by electrocardiography. Twenty patients (34%) had ventricular arrhythmias, and 38 (66%) patients had no ventricular arrhythmias. Seventeen patients had VPC, 2 patients had VPC couplets and 1 patient had ventricular tachycardia. Univariable predictors of ventricular arrhythmias included isovolumetric relaxation time and the occurrence of moderate to severe mitral regurgitation. Multivariable logistic regression analysis showed that occurrence of moderate to severe mitral regurgitation was the only independent predictor of ventricular arrhythmias (relative risk: 8.42, 95% confidence interval: 1.49–47.64, p = 0.01). Present study showed that the only independent predictor of ventricular arrhythmias in patients with MVP is the occurrence of moderate to severe mitral regurgitation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zuppiroli A, Mori F, Favilli S et al (1994) Arrhythmias in mitral valve prolapse: relation to anterior mitral leaflet thickening, clinical variables, and color Doppler echocardiographic parameters. Am Heart J 128:919–927

    Article  CAS  PubMed  Google Scholar 

  2. Lévy S (1992) Arrhythmias in the mitral valve prolapse syndrome: clinical significance and management. Pacing Clin Electrophysiol 15:1080–1088

    Article  PubMed  Google Scholar 

  3. Gooch AS, Vicencio F, Maranhao V, Goldberg H (1972) Arrhythmias and left ventricular asynergy in the prolapsing mitral leaflet syndrome. Am J Cardiol 29:611–620

    Article  CAS  PubMed  Google Scholar 

  4. Kligfield P, Levy D, Devereux RB, Savage DD (1987) Arrhythmias and sudden death in mitral valve prolapse. Am Heart J 113:1298–1307

    Article  CAS  PubMed  Google Scholar 

  5. Düren DR, Becker AE, Dunning AJ (1988) Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. J Am Coll Cardiol 11:42–47

    PubMed  Google Scholar 

  6. Pocock WA, Bosman CK, Chesler E, Barlow JB, Edwards JE (1984) Sudden death in primary mitral valve prolapse. Am Heart J 107:378–382

    Article  CAS  PubMed  Google Scholar 

  7. Diegos-Hasnier S, Copie X, Paziaud O et al (2005) Abnormalities of ventricular repolarization in mitral valve prolapse. Ann Noninvasive Electrocardiol 10:297–304

    Article  Google Scholar 

  8. Boudoulas H, Kolibash AJ, Baker P et al (1989) Mitral valve prolapse and the mitral valve prolapse syndrome: a diagnostic classification and pathogenesis of symptoms. Am Heart J 118:796–812

    Article  CAS  PubMed  Google Scholar 

  9. Coghlan JT (1979) Dysautonomia in mitral valve prolapse. Am J Med 67:236–243

    Article  CAS  PubMed  Google Scholar 

  10. Schiller NB, Shah PM, Crawford M et al (1989) Recommendations for quantitation of the left ventricle by two-dimensional echocardiography: American Society of Echocardiography Committee on Standards, Subcommitte on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 2:358–367

    CAS  PubMed  Google Scholar 

  11. Levine RA, Stathogiannis E, Newell JB et al (1988) Reconsideration of echocardiographic standards for mitral valve prolapse: lack of association between leaflet displacement isolated to the apical four chamber view and independent echocardiographic evidence of abnormality. J Am Coll Cardiol 11:1010–1019

    Article  CAS  PubMed  Google Scholar 

  12. Nishimura RA, McGoon MD, Shub C, Miller FA Jr, Ilstrup DM, Tajik AJ (1985) Echocardiographically documented mitral-valve prolapse. Long-term follow-up of 237 patients. N Engl J Med 313:1305–1309

    CAS  PubMed  Google Scholar 

  13. Zoghbi WA, Enriquez-Sarano M, Foster E et al (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802

    Article  PubMed  Google Scholar 

  14. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93:1043–1065

    Google Scholar 

  15. Bazett HC (1920) An analysis of the time-relations of electrocardiogram. Heart 7:353–367

    Google Scholar 

  16. Baedeker W (1988) Mitral valve prolapse syndrome and arrhythmias. Herz 13:318–325

    CAS  PubMed  Google Scholar 

  17. Kramer HM, Kligfield P, Devereux RB, Savage DD, Kramer-Fox R (1984) Arrhythmias in mitral valve prolapse. Effect of selection bias. Arch Intern Med 144:2360–2364

    Article  CAS  PubMed  Google Scholar 

  18. Savage DD, Levy D, Garrison RJ et al (1983) Mitral valve prolapse in the general population. 3. Dysrhythmias: the Framingham Study. Am Heart J 106:582–586

    Article  CAS  PubMed  Google Scholar 

  19. Kligfield P, Hochreiter C, Kramer H et al (1985) Complex arrhythmias in mitral regurgitation with and without mitral valve prolapse: contrast to arrhythmias in mitral valve prolapse without mitral regurgitation. Am J Cardiol 55:1545–1549

    Article  CAS  PubMed  Google Scholar 

  20. Martinez-Rubio A, Schwammenthal Y, Schwammenthal E et al (1997) Patients with valvular heart disease presenting with sustained ventricular tachyarrhythmias or syncope: results of programmed ventricular stimulation and long-term follow-up. Circulation 96:500–508

    CAS  PubMed  Google Scholar 

  21. Negi PC, Kaul U, Dev V, Bahl VK, Bajaj R (1992) Arrhythmias and conduction defects in patients with mitral valve prolapse: a study based on ambulatory monitoring and electrophysiologic studies. J Assoc Physicians India 40:367–370

    CAS  PubMed  Google Scholar 

  22. Picca M, Bisceglia J, Zocca A, Pelosi G (1994) Prevalence and severity of mitral insufficiency and arrhythmia in mitral valve prolapse. G Ital Cardiol 24:1387–1394

    CAS  PubMed  Google Scholar 

  23. Babuty D, Cosnay P, Breuillac JC et al (1994) Ventricular arrhythmia factors in mitral valve prolapse. Pacing Clin Electrophysiol 17:1090–1099

    Article  CAS  PubMed  Google Scholar 

  24. Zouridakis EG, Parthenakis FI, Kochiadakis GE, Kanoupakis EM, Vardas PE (2001) QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness. Europace 3:292–298

    Article  CAS  PubMed  Google Scholar 

  25. Sanfilippo AJ, Abdollah H, Burggraf GW (1989) Quantitation and significance of systolic mitral leaflet displacement in mitral valve prolapse. Am J Cardiol 64:1349–1355

    Article  CAS  PubMed  Google Scholar 

  26. Han L, Ho TF, Yip WC, Chan KY (2000) Heart rate variability of children with mitral valve prolapse. J Electrocardiol 33:219–224

    Article  CAS  PubMed  Google Scholar 

  27. Fauchier L, Babuty D, Cosnay P, Autret ML, Fauchier JP (1997) Heart rate variability in idiopathic dilated cardiomyopathy: characteristics and prognostic value. J Am Coll Cardiol 30:1009–1014

    Article  CAS  PubMed  Google Scholar 

  28. Levy D, Savage D (1987) Prevalence and clinical features of mitral valve prolapse. Am Heart J 113:1281–1289

    Article  CAS  PubMed  Google Scholar 

  29. Puddu PE, Pasternac A, Tubau JF et al (1983) QT interval prolongation and increased plasma catecholamine levels in patients with mitral valve prolapse. Am Heart J 105:422–426

    Article  CAS  PubMed  Google Scholar 

  30. Aviles RJ, Martin DO, Apperson-Hansen C et al (2003) Inflammation as a risk factor for atrial fibrillation. Circulation 108:3006–3010

    Article  PubMed  Google Scholar 

  31. Di Biase M, Troccoli R, Pellegrino P, Correale M, Brunetti N (2004) Correlation between C-reactive protein and ventricular arrhythmias during the acute phase of myocardial infarction. Ital Heart J 5(Suppl 1):108S–113S

    Google Scholar 

  32. Konstantino Y, Kusniec J, Reshef T et al (2007) Inflammatory biomarkers are not predictive of intermediate-term risk of ventricular tachyarrhythmias in stable CHF patients. Clin Cardiol 30:408–413

    Article  PubMed  Google Scholar 

  33. Bobkowski W, Siwińska A, Zachwieja J, Mroziński B, Paluszak W, Maciejewski J (2001) Electrolyte abnormalities and ventricular arrhythmias in children with mitral valve prolapse. Pol Merkur Lekarski 11:125–128

    CAS  PubMed  Google Scholar 

  34. Topaloglu S, Aras D, Cagli K et al (2007) Evaluation of left ventricular diastolic functions in patients with frequent premature ventricular contractions from right ventricular outflow tract. Heart Vessels 22:328–334

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gulkent State Hospital, Isparta, Turkey

    Yasin Turker

  2. Department of Cardiology, School of Medicine, Suleyman Demirel University, Isparta, Turkey

    Mehmet Ozaydin, Ercan Varol, Abdullah Dogan & Dogan Erdogan

  3. Department of Cardiology, School of Medicine, Sutcu Imam University, Kahramanmaras, Turkey

    Gurkan Acar

  4. Medical Park Hospital, Van, Turkey

    Mustafa Ozgul

  5. Department of Cardiology, School of Medicine, Baskent University, Alanya, Turkey

    Yesim Hoscan

  6. Kurtulus Mah, 122. cad. Hatice Halici apt. no: 126/15, 32040, Isparta, Turkey

    Mehmet Ozaydin

  7. Department of Cardiology, Suleyman Demirel University, Isparta, Turkey

    Habil Yucel

Authors
  1. Yasin Turker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Ozaydin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gurkan Acar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mustafa Ozgul
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yesim Hoscan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ercan Varol
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Abdullah Dogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dogan Erdogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Habil Yucel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehmet Ozaydin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Turker, Y., Ozaydin, M., Acar, G. et al. Predictors of ventricular arrhythmias in patients with mitral valve prolapse. Int J Cardiovasc Imaging 26, 139–145 (2010). https://doi.org/10.1007/s10554-009-9514-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-009-9514-6

Keywords

Search

Navigation