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Histopathological insights into mitral valve prolapse-induced fibrosis

FRONTIERS IN CARDIOVASCULAR MEDICINE (2023)

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Summary: Sudden cardiac death (SCD) can occur in mitral valve prolapse (MVP) without other comorbidities. Arrhythmic MVP (AMVP) is associated with ventricular ectopy, while malignant MVP (MMVP) has a high risk of SCD. The cause of AMVP is inflammation, fibrosis, and scarring in the left ventricle, while the exact risk of MMVP is unknown. Similar cardiac characteristics to AMVP can be seen in idiopathic SCD, suggesting a possible association. Further research is needed to identify MMVP and prevent SCD in MVP patients.

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Research Opportunities in the Treatment of Mitral Valve Prolapse

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Summary: In order to improve the outcomes for patients with mitral valve prolapse (MVP) who are at risk of severe mitral regurgitation, heart failure, or sudden cardiac death, it is crucial to identify those at higher risk. The use of advanced imaging techniques, novel omics methodologies, and web-based platforms for large-scale collaborations have provided researchers with the opportunity to make rapid advancements in the field of MVP. The National Heart, Lung, and Blood Institute has recently organized a webinar-based workshop to identify contemporary research opportunities in MVP treatment. This report highlights three specific areas of focus in the workshop: improving the management of degenerative mitral regurgitation and associated left ventricular systolic dysfunction; preventing sudden cardiac death in MVP; and understanding the mechanisms and progression of MVP through genetic studies and animal models, which may lead to the development of medical therapies.

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Native and Post-Repair Residual Mitral Valve Prolapse Increases Forces Exerted on the Papillary Muscles: A Possible Mechanism for Localized Fibrosis?

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Systematic quantification of histologic ventricular fibrosis in isolated mitral valve prolapse and sudden cardiac death

Hui-Chen Han et al.

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Summary: The study found that LV replacement myocardial fibrosis is common in patients with MVP, associated with mitral valve apparatus alteration, more dilated LV, MR grade, and ventricular arrhythmia, and independently associated with cardiovascular events. These findings suggest an MVP-related myocardial disease, with cardiac magnetic resonance providing additional information for MVP patients.

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Begona Lopez et al.

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