Need for expertise in mitral valve regurgitation

Donal, Erwan; Galli, Elena; Letourneau, Thierry

doi:10.1136/openhrt-2019-001039

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Levels of soluble suppression of tumorgenicity 2 (sST2), an IL-1R family member secreted by cardiac cells in response to biomechanical stress that can promote myocardial fibrosis, may be useful in risk-stratifying patients with MAD for ventricular arrhythmias. 40,55 In a study of 72 patients with at least 1 mm of MAD on CMR, 31% had aborted cardiac arrest, sustained VT, or NSVT. Patients with ventricular arrhythmias had higher average sST2 levels, lower ejection fraction, and more frequent papillary muscle fibrosis on CMR.…”

Section: Risk Predictorsmentioning

confidence: 99%

Imaging Considerations and Clinical Implications of Mitral Annular Disjunction

Drescher

Kelsey

Yankey

et al. 2022

Circ: Cardiovascular Imaging

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Mitral annular disjunction is increasingly recognized as an important anatomic feature of mitral valve disease. The presence of mitral annular disjunction, defined as separation between the left atrial wall at the point of mitral valve insertion and the left ventricular free wall, has been associated with increased degeneration of the mitral valve and increased incidence of sudden cardiac death. The clinical importance of this entity necessitates standard reporting on cardiovascular imaging reports if patients are to receive adequate risk stratification and management. We provide a narrative review of the literature pertaining to mitral annular disjunction, its clinical implications, and areas needing further research.

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Section: Risk Predictorsmentioning

confidence: 99%

Imaging Considerations and Clinical Implications of Mitral Annular Disjunction

Drescher

Kelsey

Yankey

et al. 2022

Circ: Cardiovascular Imaging

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“…This is important for the balanced distribution of mechanical stresses. 10,11 Mitral valve prolapse is estimated to affect approximately 2 to 3% of the general population. The clinical outcomes are highly variable and depend on factors like age, degree of mitral regurgitation, LVEF, ventricular ectopy, and atrial diameters.…”

Section: Discussionmentioning

confidence: 99%

Mitral Annulus Disjunction and Arrhythmic Mitral Valve Prolapse: Emerging Role of Cardiac Magnetic Resonance Imaging in the Workup

Kulkarni¹,

Chudgar²,

Burkule³

et al. 2022

Indian J Radiol Imaging

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Mitral valve prolapse is a commonly described entity with a highly variable and benign course. However, it is associated with ventricular arrhythmias and sudden cardiac death in a small subset of patients. Recent studies have yielded insight into myocardial mechanics and the causation of ventricular arrhythmias in these groups of patients.Mitral annular disjunction (MAD) characterized by detachment of mitral annulus from left ventricular myocardium is associated with morphological and functional remodeling of the left ventricular myocardium. Resultant fibrosis acts as a substrate of ventricular arrhythmia and sudden cardiac death.We present two such cases of arrhythmic mitral valve prolapse associated with MAD. Cardiac magnetic resonance imaging provides excellent morphological information and also helps in the assessment of fibrosis.

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“…1 and 2 ) [ 1 ]. MAD is prevalent in patients with mitral valve disease particularly mitral valve prolapse [ 2 ]. It is thought to lead to paradoxical annular enlargement and annular flattening in ventricular systole which increases the stress placed on the mitral valve apparatus [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic description and outcomes in a heterogeneous cohort of patients undergoing mitral valve surgery with and without mitral annular disjunction: a health service evaluation

et al. 2022

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Background Mitral annular disjunction (MAD) is a structural abnormality characterized by the distinct separation of the mitral valve annulus/left atrium wall and myocardium. Little is known about the significance of MAD in patients requiring mitral valve surgery. This evaluation evaluates the echocardiographic characteristics and patient outcomes for patients with and without MAD who require mitral valve surgery. Methods All patients who underwent mitral valve surgery and who had a pre-surgical transthoracic echocardiogram between 2013 and 2020 were included. Patient demographics and clinical outcomes were collected on review of patient electronic records. Results A total of 185 patients were included in the analysis of which 32.4% had MAD (average MAD length 8.4 mm). MAD was seen most commonly in patients with mitral valve prolapse and myxomatous mitral valves disease (90% and 60% respectively). In the patients with MAD prior to mitral valve surgery, only 3.9% had MAD post mitral valve surgery. There were no significant difference in the severity of post-operative mitral regurgitation, arrhythmic events or major adverse cardiovascular events in patients with and without MAD. Conclusions MAD is common in patients who undergo mitral valve surgery. Current surgical techniques are able to correct the MAD abnormality in the vast majority of patients. MAD is not associated with an increased risk of adverse clinical outcomes post mitral valve surgery.

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Need for expertise in mitral valve regurgitation

Cited by 3 publications

References 12 publications

Imaging Considerations and Clinical Implications of Mitral Annular Disjunction

Imaging Considerations and Clinical Implications of Mitral Annular Disjunction

Mitral Annulus Disjunction and Arrhythmic Mitral Valve Prolapse: Emerging Role of Cardiac Magnetic Resonance Imaging in the Workup

Echocardiographic description and outcomes in a heterogeneous cohort of patients undergoing mitral valve surgery with and without mitral annular disjunction: a health service evaluation

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