Anterior mitral valve length is associated with ventricular tachycardia in patients with classical mitral valve prolapse.
BACKGROUND
The aim of this study was to investigate the electrocardiographic and echocardiographic predictors of ventricular tachycardia (VT) in patients with classical mitral valve prolapse (MVP).


METHODS
Thirty patients (nine men and 21 women; mean age, 41.5 ± 15 years) in sinus rhythm with mitral valve prolapse who had VT in 24-hour Holter analysis and 30 patients with MVP without VT (eight men and 22 women; mean age, 43 ± 16 years) were included in this study. Transthoracic echocardiography, QT analyses from 12-lead electrocardiography, and 24-hour Holter electrocardiogram recordings were performed.


RESULTS
Mitral posterior leaflet thickness (0.48 ± 0.03 cm vs 0.43 ± 0,08 cm, P = 0.025), mitral anterior leaflet length (3.2 ± 0.24 cm vs 2.9 ± 0.36, P < 0.001), mitral posterior leaflet length (2.2 ± 0.3 cm vs 1.9 ± 0.35 cm, P = 0.01), left atrium anteroposterior diameter (4.2 ± 0.8 cm vs 3.5 ± 0.5 cm, P = 0.001), and mitral annulus circumference (15.7 ± 1.3 cm vs 14.6 ± 1.6 cm, P = 0.004) were increased significantly in MVP cases with VT. No significant difference was found between the cases with and without VT in terms of frequency- and time-domain analysis. QT dispersion (72 ± 18 ms vs 55 ± 15 ms, P = 0.0002) and corrected QT dispersion (QTcD) (76 ± 18 ms vs 55 ± 15 ms, P = 0.0002) were significantly increased in cases with VT compared with those without VT. Based on logistic regression analysis for MVP cases, in the case of VT, an enhancement in QTcD (P = 0.01) and the mitral anterior leaflet length (P = 0.003) were the independent predictors of VT.


CONCLUSIONS
Mitral anterior leaflet length and enhanced QTcD are closely related with VT in patients with classical MVP.
Akcay
Murat
M
Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey. drmuratakcay@yahoo.com
Yuce
Murat
M
Pala
Selcuk
S
Akcakoyun
Mustafa
M
Ergelen
Mehmet
M
Kargin
Ramazan
R
Emiroglu
Yunus
Y
Ozdemir
Nihal
N
Kaymaz
Cihangir
C
Ozkan
Mehmet
M
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography