Mitral valve prolapse and sudden cardiac arrest in the community

Kumar Narayanan, Audrey Uy-Evanado, Carmen Teodorescu, Kyndaron Reinier, Gregory A. Nichols, Karen Gunson, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Background Mitral valve prolapse (MVP) is relatively common in the general population with recently reported prevalence of 1% and familial clustering (Framingham Heart Study). However, its association with ventricular arrhythmias and sudden cardiac arrest (SCA) remains controversial. Objectives The purpose of this study was to characterize the frequency and clinical profile of patients with MVP who suffer SCA in the community. Methods Patients with SCA cases were prospectively identified in the population-based Oregon Sudden Unexpected Death Study (population ~1 million). The presence of MVP was identified from echocardiograms recorded prior but unrelated to the SCA event. The detailed clinical profile of patients with SCA and MVP was compared with that of SCA patients without MVP to identify potential differences. Results A total of 729 SCA patients were evaluated over a 12-year period (mean age 69.5 ± 14.8 years; 64.6% men). MVP was observed in 17 (2.3%) prior to the SCA event (95% confidence interval 1.2%-3.4%). Mitral regurgitation was present in 14 SCA patients with MVP (82.3%) and was moderate or severe in 10 (58.8%). Compared with SCA patients without MVP, SCA patients with MVP were younger (mean age 60.9 ± 16.4 years vs 69.7 ± 14.7 years; P =.02), with fewer risk factors (diabetes 5.9% vs 46.4%; P =.001; hypertension 41.2% vs 78.9%; P =.001) or known coronary disease (29.4% vs 65.6%; P <.001). Conclusion MVP was observed in a small proportion (2.3%) of SCA patients in the general population, suggesting a low risk overall. Since SCA patients with MVP were characterized by younger age and relatively low cardiovascular comorbidity, a focus on imaging for valve structure/insufficiency as well as genetics could aid future risk stratification approaches.

Original languageEnglish (US)
Pages (from-to)498-503
Number of pages6
JournalHeart Rhythm
Volume13
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • Mitral valve prolapse
  • Risk
  • Sudden cardiac arrest

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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  • Cite this

    Narayanan, K., Uy-Evanado, A., Teodorescu, C., Reinier, K., Nichols, G. A., Gunson, K., Jui, J., & Chugh, S. S. (2016). Mitral valve prolapse and sudden cardiac arrest in the community. Heart Rhythm, 13(2), 498-503. https://doi.org/10.1016/j.hrthm.2015.09.026