Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse

التفاصيل البيبلوغرافية
العنوان: Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse
المؤلفون: Stefano Figliozzi, Georgios Georgiopoulos, Pedro M. Lopes, Klemens B. Bauer, Sara Moura-Ferreira, Lara Tondi, Saima Mushtaq, Stefano Censi, Anna Giulia Pavon, Ilaria Bassi, Maria Luz Servato, Arco J. Teske, Federico Biondi, Domenico Filomena, Silvia Pica, Camilla Torlasco, Denisa Muraru, Pierre Monney, Giuseppina Quattrocchi, Viviana Maestrini, Luciano Agati, Lorenzo Monti, Patrizia Pedrotti, Bert Vandenberk, Angelo Squeri, Massimo Lombardi, António M. Ferreira, Juerg Schwitter, Giovanni Donato Aquaro, Amedeo Chiribiri, José F. Rodríguez Palomares, Ali Yilmaz, Daniele Andreini, Anca Florian, Tim Leiner, João Abecasis, Luigi Paolo Badano, Jan Bogaert, Pier-Giorgio Masci
المساهمون: Figliozzi, S, Georgiopoulos, G, Lopes, P, Bauer, K, Moura-Ferreira, S, Tondi, L, Mushtaq, S, Censi, S, Pavon, A, Bassi, I, Servato, M, Teske, A, Biondi, F, Filomena, D, Pica, S, Torlasco, C, Muraru, D, Monney, P, Quattrocchi, G, Maestrini, V, Agati, L, Monti, L, Pedrotti, P, Vandenberk, B, Squeri, A, Lombardi, M, Ferreira, A, Schwitter, J, Aquaro, G, Chiribiri, A, Rodríguez Palomares, J, Yilmaz, A, Andreini, D, Florian, A, Leiner, T, Abecasis, J, Badano, L, Bogaert, J, Masci, P
المصدر: Radiology. 306(1)
سنة النشر: 2022
مصطلحات موضوعية: Radiology, Nuclear Medicine and imaging, myocardial fibrosis, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, mitral valve prolapse, cardiac magnetic resonance
الوصف: Background: Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose: To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods: In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results: A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; P = .03). Conclusion: In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction.
وصف الملف: STAMPA
تدمد: 1527-1315
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0cd442a9ab5dd391e01d9d533e36bfcfTest
https://pubmed.ncbi.nlm.nih.gov/36098646Test
حقوق: CLOSED
رقم الانضمام: edsair.doi.dedup.....0cd442a9ab5dd391e01d9d533e36bfcf
قاعدة البيانات: OpenAIRE
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