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Supraventricular arrhythmia in mitral valve prolapse

Predictive value of P-wave dispersion and atrial conduction time

Supraventrikuläre Arrhythmien bei Mitralklappenprolaps

Prädiktiver Wert der P-Wellen-Dispersion und der Vorhofüberleitungszeit

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Abstract

Background

The incidence of supraventricular arrhythmia (SVA) is high in patients with mitral valve prolapse (MVP). The purpose of our study was to determine the role of parameters showing atrial conduction heterogeneity such as P‑wave dispersion (PWD) and atrial electromechanical delay (AEMD) in predicting the development of SVA in MVP patients.

Methods

A total of 76 patients with MVP (56 female, 20 male) were included in the study. The patients were divided into two groups according to the presence or absence of SVA: 36 patients were allocated to the non-SVA group and 40 patients to the SVA group. Heart rate variability (HRV), PWD, and AEMD values were determined and compared.

Results

The PWD was found to be higher in the SVA group. Interatrial EMD was 32.00 ms (25.00–35.00) in patients with SVA while it was 18.00 ms in patients without SVA (11.00–23.75); the intra-atrial EMD was 17.0 ms (10.00–20.00) in patients with SVA whereas it was 10.00 ms (4.00–14.00) in patients without SVA. Lower HRV was found in the SVA group.

Conclusion

In the SVA group, PWD and AEMD were increased while HRV values were decreased. Noninvasive parameters may help predict the presence and incidence of SVA during the follow-up of this group of patients.

Zusammenfassung

Hintergrund

Die Inzidenz supraventrikulärer Arrhythmien (SVA) ist bei Patienten mit Mitralklappenprolaps (MVP) hoch. Ziel der vorliegenden Arbeit war es, für die Vorhersage der Entwicklung von SVA bei MVP-Patienten die Bedeutung von Parametern zu ermitteln, welche den Nachweis einer Heterogenität der Vorhofüberleitung liefern, z. B. die P‑Wellen-Dispersion (PWD) und die atriale elektromechanische Verzögerung (AEMD).

Methoden

Dazu wurden 76 Patienten mit MVP (56 Frauen, 20 Männer) in die Studie einbezogen. Die Patienten wurden – je nach Vorliegen von SVA oder nicht – in 2 Gruppen unterteilt: Der Non-SVA-Gruppe wurden 36 Patienten zugewiesen und der SVA-Gruppe 40 Patienten. Herzfrequenzvariabilität (HRV), PWD und AEMD-Werte wurden ermittelt und verglichen.

Ergebnisse

In der SVA-Gruppe erwies sich die PWD als höher denn in der Vergleichsgruppe. Die interatriale EMD betrug 32,00 ms (25,00–35,00) bei Patienten mit SVA, während sie 18,00 ms bei Patienten ohne SVA betrug (11,00–23,75); die intraatriale EMD lag bei 17,0 ms (10,00–20,00) bei Patienten mit SVA, dagegen bei 10,00 ms (4,00–14,00) für Patienten ohne SVA. In der SVA-Gruppe wurde eine niedrigere HRV festgestellt.

Schlussfolgerung

In der SVA-Gruppe waren PWD und AEMD erhöht, während die HRV-Werte niedriger waren. Noninvasive Parameter können möglicherweise zur Vorhersage des Vorliegens und der Inzidenz von SVA im Rahmen der Nachuntersuchung bei dieser Patientengruppe beitragen.

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References

  1. ACC-AHA guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association. Task Force on Practice Guidelines. J Am Coll Cardiol 1998; 32:1486–588.

  2. Yosefy C, Barak BA (2007) Floppy mitral valve/mitral valve prolapse and genetics. J Heart Valve Dis 16:590–595

    PubMed  Google Scholar 

  3. Mson DT, Lee G, Chan MC, DeMaria AN (1984) Arrhytmias in patients with mitral valve prolapse. Types, evaluation, and therapy. Med Clin North Am 68(5):1039–1049

    Article  Google Scholar 

  4. Van der Wall EE, Schalij MJ (2010) Mitral valve prolapse: a source of arrhytmias? Int J Cardiovasc Imaging 26(2):147–149

    Article  Google Scholar 

  5. 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(5):919–927

    Article  CAS  Google Scholar 

  6. Turker Y, Ozaydın M, Acar G et al (2010) Predictors of ventricular arrhythmias in patients with mitral valve prolapse. Int J Cardiovasc Imaging 26(2):139–145

    Article  Google Scholar 

  7. Turker Y, Ozaydın M, Acar G et al (2009) Predictors of atrial arrhythmias in patients with mitral valve prolapse. Acta Cardiol 64(6):755–760

    Article  Google Scholar 

  8. Çetinkaya M, Semizel E, Bostan O, Çil E (2008) Risk of vasovagal syncope and cardiac arrhytmias in children with mitral valve prolapse. Acta Cardiol 63:395–398

    Article  Google Scholar 

  9. Zouridakis EG, Parthenakis GE, Kochiadakis EM et al (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  Google Scholar 

  10. Markiewicz-Loskot G, Loskot M, Moric-Janiszewska E et al (2009) Electrocardiographic abnormalities in young athletes with mitral valve prolapse. Clin Cardiol 32(8):E36–E39

    Article  Google Scholar 

  11. Kleiger RE, Stein PK, Bigger JT Jr. (2005) Heart rate variability: measurement and clinical utility. Ann Noninvasive Electrocardiol 10:88–101

    Article  Google Scholar 

  12. Nussinovitch U (2012) Meta-analysis of P‑wave dispersion values in healthy individuals: the influence of clinical characteristics. Ann Noninvasive Electrocardiol 17(1):28–35

    Article  Google Scholar 

  13. Dilaveris PE, Gialafos EJ (2001) P wave dispersion: a novel predictor of paroxysmal atrşal fibrillation. Ann Noninvasive Electrocardiol 6(2):159–165

    Article  CAS  Google Scholar 

  14. Saravi M, Montazeri M (2008) Effect of left atria size on p‑wave dispersion: a study in patients with paroxysmal atrial fibrillation. ARYA Atheroscler J 4(1):67–72

    Google Scholar 

  15. Bayes de Luna A, Cladellas M, Oter R et al (1988) Interatrial conduction block and retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmia. Eur Heart J 9:1112–1118

    Article  CAS  Google Scholar 

  16. Calık AN, Ozcan KS, Cagdas M et al (2014) Electromechanical delay detected by tissue doppler echocardiography is associated with the frequency of attacks in patients with lone atrial fibrillation. Cardiol J 21(2):138–143

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Cardiology Department, SBU Antalya Training and Research Hospital, Antalya, Turkey

    Zehra Erkal MD, Nermin Bayar MD, Associate Professor, Erkan Koklu MD, Associate Professor, Goksel Cagırcı MD, Professor & Sakir Arslan MD, Professor

  2. Emergency Medicine Department, SBU Kanuni Sultan Suleyman Training and Research Hospita, Istanbul, Turkey

    Ramazan Guven MD, Associate Professor

Authors
  1. Zehra Erkal MD
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  2. Nermin Bayar MD, Associate Professor
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  3. Erkan Koklu MD, Associate Professor
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  4. Goksel Cagırcı MD, Professor
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  5. Sakir Arslan MD, Professor
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  6. Ramazan Guven MD, Associate Professor
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Correspondence to Zehra Erkal MD.

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Conflict of interest

Z. Erkal, N. Bayar, E. Koklu, G. Cagırcı, S. Arslan, and R. Guven declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. This retrospective study was performed after consultation with the institutional ethics committee and in accordance with national legal requirements.

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Erkal, Z., Bayar, N., Koklu, E. et al. Supraventricular arrhythmia in mitral valve prolapse. Herz 47, 67–72 (2022). https://doi.org/10.1007/s00059-021-05034-1

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  • DOI: https://doi.org/10.1007/s00059-021-05034-1

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