Cameron James N, Sutherland Nigel, Chow Chee Loong, Han Hui-Chen, Yudi Matias, Mahajan Rajiv, Ganesan Anand, Sabbag Avi, Haugaa Kristina H, Raman Jai, Sanders Prashanthan, Farouque Omar, Lim Han S
Department of Cardiology Austin Health Melbourne Victoria Australia.
Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Melbourne Victoria Australia.
J Arrhythm. 2025 Jul 15;41(4):e70108. doi: 10.1002/joa3.70108. eCollection 2025 Aug.
Several autopsy and observational studies have investigated the link between mitral valve prolapse (MVP) and sudden cardiac death (SCD) given the well accepted yet rare occurrence of ventricular arrhythmias (VA). Whether surgical intervention for arrhythmogenic MVP (aMVP) reduces VA and SCD risk remains unknown.
A systematic literature review was conducted using the PubMed database in December 2024. Studies documented in English were included if patients had undergone mitral valve (MV) surgery (MVS; repair or replacement) for MVP with documented rates of VA or SCD pre- and postintervention.
Sixteen identified studies (8 cohort and 8 case studies) comprised 1233 patients (receiving medical or surgical treatment) with a pooled mean age of 61.5 years and 41.9% being female. A total of 657 MVP patients underwent MVS. Seven cohort studies reported rates of VA pre- and postintervention, with six of these and all case studies reporting a significant reduction. The remaining cohort study reported a reduction in SCD.
This systematic review indicates a reduction in VA following current guideline-directed MVS for MVP. However, a residual risk of VA and SCD may remain postintervention.
鉴于室性心律失常（VA）虽已被广泛认可但发生率较低，多项尸检和观察性研究探讨了二尖瓣脱垂（MVP）与心源性猝死（SCD）之间的联系。对于致心律失常性MVP（aMVP）的手术干预是否能降低VA和SCD风险仍不清楚。
2024年12月使用PubMed数据库进行了系统的文献综述。如果患者因MVP接受了二尖瓣（MV）手术（MVS；修复或置换），且记录了干预前后的VA或SCD发生率，则纳入以英文记录的研究。
16项纳入研究（8项队列研究和8项病例研究）共1233例患者（接受药物或手术治疗），平均年龄61.5岁，女性占41.9%。共有657例MVP患者接受了MVS。7项队列研究报告了干预前后的VA发生率，其中6项队列研究及所有病例研究均报告VA发生率显著降低。其余队列研究报告SCD有所减少。
本系统综述表明，按照当前指南对MVP进行MVS后，VA发生率降低。然而，干预后可能仍存在VA和SCD的残余风险。
