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心律失常性二尖瓣脱垂综合征:对理解心律失常基质的新见解?

The Arrhythmic Mitral Valve Prolapse Syndrome: A New Insight for Understanding the Arrhythmogenic Substrate?

作者信息

Ghelani Rahul, Chow Ji-Jian, Miyazawa Alejandra, Artico Jessica, Cole Graham, Kanagaratnam Prapa, Peters Nicholas S, Varnava Amanda

机构信息

Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare Trust, London, United Kingdom.

Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare Trust, London, United Kingdom.

出版信息

JACC Case Rep. 2025 May 28;30(12):103419. doi: 10.1016/j.jaccas.2025.103419. Epub 2025 Apr 24.

Abstract

BACKGROUND

Mitral valve prolapse (MVP) is the most common valvular heart disease and historically was considered benign in the absence of severe mitral regurgitation and normal left ventricular function. However, an emerging subset associated with sudden cardiac death that does not follow traditional risk stratification has been established termed the arrhythmic mitral valve prolapse (A-MVP) syndrome. This cohort provide a clinical challenge on identifying those at risk of lethal arrhythmias who may benefit from a primary prevention implantable cardiac defibrillator.

CASE SUMMARY

We present 7 cases in which patients have survived cardiac arrest due to A-MVP, with the aim of further describing phenotypic characteristics that define this syndrome.

DISCUSSION

We observed that after arrest, a high proportion of patients developed rapidly worsening mitral regurgitation. This observed link may provide insight into the underlying substrate of arrhythmogenesis.

摘要

背景

二尖瓣脱垂(MVP)是最常见的心脏瓣膜病,在历史上,若不存在严重二尖瓣反流且左心室功能正常,则被认为是良性的。然而,已确定存在一个与心脏性猝死相关的新亚组,该亚组不遵循传统的风险分层,被称为心律失常性二尖瓣脱垂(A-MVP)综合征。这一队列给识别那些可能从一级预防植入式心脏除颤器中获益的致命性心律失常风险患者带来了临床挑战。

病例总结

我们呈现7例因A-MVP导致心脏骤停后存活的病例,目的是进一步描述定义该综合征的表型特征。

讨论

我们观察到,在心脏骤停后,很大一部分患者出现二尖瓣反流迅速恶化的情况。这一观察到的关联可能为心律失常发生的潜在机制提供见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e2b/12235458/75f9bbdb2ca7/ga1.jpg

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