Prevalence, clinical significance, and risk factors of arrhythmic mitral valve prolapse — results of the MITPROL AR-PL Registry

BACKGROUND: Mitral valve prolapse (MVP) may increase ventricular arrhythmic burden. AIMS: To assess prevalence, clinical significance, risk factors of arrhythmic MVP (aMVP) of the Polish MVP population. METHODS: 454 adult MVP patients were enrolled into MITPROL AR-PL (Mitral Valve Prolapse Polish Registry). Patients with proarrhythmic comorbidities and severe mitral regurgitation were excluded. The study population was divided according to EHRA (European Heart Rhythm Association) 2022 consensus into aMVP, non-arrhythmic MVP (non-aMVP). Demographics, symptoms, electrocardiogram and MVP morphology were analyzed. RESULTS: The aMVP was diagnosed in 61 (13.5%, mean age 45.0 years, females: 46/75%) and non-aMVP in 215 (47.4%, mean age 47.9 years, females: 157/73%) patients. Differences regarding symptoms were not recorded. Comparison between aMVP and non-aMVP showed a more frequent presence of Barlow's disease (52.5 vs. 25.1%, P < 0.001), bileaflet prolapse (75.4 vs. 47.9%, P < 0.001), Pickelhaube sign (41.0 vs. 21.4%, P = 0.002), mitral annulus disjunction (MAD; 73.8 vs. 48.8%, P < 0.001), inferior leads T-wave inversion (26.2 vs. 13.5%, P = 0.0001) in the aMVP. MAD length (8.4 vs. 8.0 mm, P = 0.04), maximum prolapse depth (5.7 vs. 4.6 mm, P < 0.001), leaflet thickness (5.5 vs. 4.6 mm, P = 0.001) were higher in the aMVP. Multivariable logistic regression showed predictors for aMVP: maximum prolapse depth (OR, 1.21; CI, 1.02-1.45, P = 0.02), leaflet thickness (OR, 1.51, CI, 1.17-1.94, P = 0.001). CONCLUSIONS: The aMVP is rare. Maximum prolapse depth,leaflet thickness are independent aMVP risk factors. Screening for aMVP is reasonable in the MVP population regardless of arrhythmic symptoms with advanced prolapse, without well-recognized proarrhythmic factors.

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Journal
Kardiologia Polska
Published
2026-07-22
DOI
https://doi.org/10.33963/v.phj.113744
Primary Topic
Cardiac Valve Diseases and Treatments
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article
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article

Prevalence, clinical significance, and risk factors of arrhythmic mitral valve prolapse — results of the MITPROL AR-PL Registry

Katarzyna Kurnicka, Małgorzata Kamela, Jacek Bil, Radosław Piątkowski et al.
Kardiologia Polska
Cardiac Valve Diseases and Treatments
article

Prevalence, clinical significance, and risk factors of arrhythmic mitral valve prolapse — results of the MITPROL AR-PL Registry

Katarzyna Kurnicka, Małgorzata Kamela, Jacek Bil, Radosław Piątkowski, Olga Możeńska, Kamil Barański, Agnieszka Boruc, Anna Polewczyk, Mateusz Staciwa, Tomasz Kukulski, Michał Plewka, Andrzej Gackowski, Barbara Brzezińska, Danuta Sorysz, Marek Koziński, Karolina Golińska‐Grzybała, Renata Wachnicka‐Truty, Ewa Wołoszyn-Horák, Dominika Dziadosz, P Wejner - Mik, Piotr Duchnowski, Ludmiła Daniłowicz, Małgorzata Knapp, Monika Kowalczyk-Domagała, J D Kasprzak, K Mizia-Stec, Karina Wierzbowska-Drabik, Dorota Kustrzycka-Kratochwil, P Szymanski, K Jaworski, Zofia Oko-Sarnowska, Ireneusz Jedliński, Klaudia Mickiewicz, Beata Uzieblo-Zyczkowska
article en

Abstract

BACKGROUND: Mitral valve prolapse (MVP) may increase ventricular arrhythmic burden. AIMS: To assess prevalence, clinical significance, risk factors of arrhythmic MVP (aMVP) of the Polish MVP population. METHODS: 454 adult MVP patients were enrolled into MITPROL AR-PL (Mitral Valve Prolapse Polish Registry). Patients with proarrhythmic comorbidities and severe mitral regurgitation were excluded. The study population was divided according to EHRA (European Heart Rhythm Association) 2022 consensus into aMVP, non-arrhythmic MVP (non-aMVP). Demographics, symptoms, electrocardiogram and MVP morphology were analyzed. RESULTS: The aMVP was diagnosed in 61 (13.5%, mean age 45.0 years, females: 46/75%) and non-aMVP in 215 (47.4%, mean age 47.9 years, females: 157/73%) patients. Differences regarding symptoms were not recorded. Comparison between aMVP and non-aMVP showed a more frequent presence of Barlow's disease (52.5 vs. 25.1%, P < 0.001), bileaflet prolapse (75.4 vs. 47.9%, P < 0.001), Pickelhaube sign (41.0 vs. 21.4%, P = 0.002), mitral annulus disjunction (MAD; 73.8 vs. 48.8%, P < 0.001), inferior leads T-wave inversion (26.2 vs. 13.5%, P = 0.0001) in the aMVP. MAD length (8.4 vs. 8.0 mm, P = 0.04), maximum prolapse depth (5.7 vs. 4.6 mm, P < 0.001), leaflet thickness (5.5 vs. 4.6 mm, P = 0.001) were higher in the aMVP. Multivariable logistic regression showed predictors for aMVP: maximum prolapse depth (OR, 1.21; CI, 1.02-1.45, P = 0.02), leaflet thickness (OR, 1.51, CI, 1.17-1.94, P = 0.001). CONCLUSIONS: The aMVP is rare. Maximum prolapse depth,leaflet thickness are independent aMVP risk factors. Screening for aMVP is reasonable in the MVP population regardless of arrhythmic symptoms with advanced prolapse, without well-recognized proarrhythmic factors.

Kardiologia Polska
Poznan University of Medical Sciences (PL), Jagiellonian University (PL), National Academy of Medicine (US), Medical University of Białystok (PL), Medical University of Silesia (PL), Medical University of Warsaw (PL), Military Hospital (PK), John Paul II Hospital (PL), Children's Memorial Health Institute (PL), Medical University of Lodz (PL), Ministry of Interior and Administration (PL), Silesian Center for Heart Disease (PL), Institute of Cardiology (PL), Central Clinical Hospital (PL), Wojskowy Instytut Higieny i Epidemiologii (PL), ERN GUARD-Heart (NL), 2P-Info (Poland) (PL), Narodowy Instytut Leków (PL), Cardinal Stefan Wyszynski University in Warsaw (PL), Gdańsk Medical University (PL)
Good health and well-being
Openalex Percentile: Top 8%
Cardiac Valve Diseases and Treatments
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