The cardiac valve anomaly is associated with malignant arrhythmias, the study reveals

People with a certain abnormality of the heart valve run an increased risk of serious heart rate disorders, even after successful valve surgery. This is according to a new study, “mitral annular disjunction and prolapse of the mitral valve: long -term risk of ventricular arrhythmias after surgery” of the Karolinska Institute and the Karolinska University Hospital in Sweden, published in Karolinska European Heart Journal.

The condition is more frequent in women and younger patients suffering from valve disorder and can, in the worst case, cause sudden cardiac arrest.

The crazy mitral annular disjunction is a cardiac anomaly in which the attachment of the mitral valve “slides”. In recent years, the condition has been linked to an increased risk of severe cardiac arrhythmias. So far, it is not known whether the risk of arrhythmias disappears if Mad is surgically corrected.

MAD is often associated with heart disease called prolapse of the mitral valve, which affects 2.5% of the population and runs one of the valves of the heart. This can lead the blood to be pumped back in the heart, causing heart failure and arrhythmias. The disease can cause symptoms such as shortness of breath and palpitations.

Depending on patients after surgery

In this study, researchers from the Karolinska Institute studied the risk of heart arrhythmias in 599 patients with prolapse mitral valve who underwent heart surgery at the Karolinska university hospital between 2010 and 2022. Some 16% of patients also had a MAD cardiac anomaly.

“We have been able to show that people with MAD have a significantly higher risk of suffering from ventricular arrhythmias, a dangerous type of heart rate disorder which, in the worst case, can lead to cardiac arrest in a subset of patients,” said Bahira Shahim, Associate Professor in the Department of Medicine, Solna, Karolinska Institute and Cardiologist in Karolinska University Hospital.

People with Mad have been more likely to be women and had an average of eight years less than those without mad. They also had a larger mitral valve disease. Although surgery has managed to correct Mad, these patients had more than three times the risk of ventricular arrhythmias for five years of follow -up compared to preoperative PAD patients.

“Our results show that it is important to closely monitor patients with this condition, even after a successful operation,” said Bahira Shahim.

Investigate

The study has led to new hypotheses that researchers are studying now. One hypothesis is that Mad causes permanent changes in the heart muscle over time. Another is that Mad is a sign of an underlying heart muscle disease.

Researchers now continue to study the scars in the heart using MRI (magnetic resonance imaging) and analyze fabric samples of the heart muscle.

The research was led by the cardiologist and associate professor Bahira Shahim in close collaboration with Magnus Dalen, associate professor at the Karolinska Institute and cardiac surgeon at the Karolinska University Hospital, and Klara Lodin, PH.D. Student in Karolinska Institutet.