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QT Variables of Isolated Mitral Valve Prolapse

Year 2007, Volume: 9 Issue: 2, 19 - 24, 01.07.2007

Abstract

Purpose: It is thought that arrhythmias are responsible for sudden deaths in patients with mitral valve prolapse (MVP). QT intervals may predict malignant arrhythmia potential in these patients. The aim of the present study is to assess QT variables in patients with MVP. Methods : We studied 46 patients with non-rheumatic, uncomplicated and isolated MVP and 25 healthy control subjects. All individuals underwent full M-mode; two -dimensional and color-Doppler examinations. MVP was defined as superior displacement of the mitral leaflets of more than 2 mm during systole and as a maximal leaflet thickness of at least 5 mm during diastole. Maximum (QTmax), minimum (QTmin) durations, corrected QT intervals and QT dispersion were measured in every case. The results of MVP patients were compared with the data gathered from the control cases. Results: Demographic and clinical variables were similar between the two groups. Anterior mitral leaflet thickness (AMLD), maximal leaflet displacement (DMR) and degree of mitral regurgitation (DMR) were found to be significantly higher in the patient group. QTc max, QT dispersion (QTd) and corrected QT dispersion (QTcD) were also significantly higher in MVP patients. A significant and fairly strong correlation was found between QTc max, QTcD and AMLT, MLD and DMR. Conclusion: QT durations were significantly increased in patients with isolated MVP, which may explain increased incidence of ventricular arrhythmias and sudden death in this population. Furthermore QT variables were related with the mitral leaflet thickness and degree of mitral regurgitation; which means QT variables increases with the the severity of the disease

References

  • 1. Dören DR, Becker AE, Dunning AS: Long term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. J Am Coll Cardiol. 11:42–47, 1988.
  • 2. Kligfield P, Devereux RB: Arrhythmias in mitral valve prolapse. Clin Prog Electrophysiol Pacing. 3:403-418, 1985.
  • 3. Sanfilippo AJ, Abdollah H, Burggraf GW: Quantification and significance of systolic mitral leaflet displacement in mitral valve prolapse. Am J Cardiol. 64:1349-1355, 1989.
  • 4. Bekheit SG, Ali AA, Deglin SM, Jain AC: Analysis of QT interval in patients with idiopathic mitral valve prolapse. Chest. 81: 620–625, 1982.
  • 5. Puddu PE, Pasternac A, Tubau JF, Krol R, Farley L, de Champlain J: QT interval prolongation and increased plasma catecholamine levels in patients with mitral valve prolapse. Am Heart J. 105: 422–428, 1983.
  • 6. Henry WL, DeMaria A, Gramiak R King DL, Kisslo JA, Popp RL, Sahn DJ, Schiller NB, Tajik A, Teichholz LE, Weyman AE: Report of the American Society of Echocardiography Comitee on Nomenclature and Standarts in two dimensional imaging. Circulation. 62: 212-217, 1980.
  • 7. Freed LA, Levy D, Levine RA, Larson MG, Evans JC, Fuller DL, Lehman B, Benjamin EJ: Prevalance and clinical outcome of mitralvalve prolapse. New Eng J Med. 341: 1-7, 1999.
  • 8. Devereux RB. Reichek N: Echocardiographic determinationation of left ventricular mass in mann: Comparison to necropsy findings. Circulation. 55: 613-617, 1977.
  • 9. DuBois D, DuBois EF: Clinical calorimetry: A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 17: 863-871, 1916.
  • 10. Kligfield P, Levy D, Devereux RB, Savage DD: Arrhythmias and sudden death in mitral valve prolapse. Am Heart J. 113:1298-1307, 1987.
  • 11. Ulgen MS, Biyik I, Karadede A, Temamogullari AV, Alan S, Toprak N: Relation between QT dispersion and ventricular arrhythmias in uncomplicated isolated mitral valve prolapse. Jpn Circ J. 63: 929-933, 1999.
  • 12. Levy D, Savage D: Prevalence and clinical features of mitral valve prolapse. Am Heart J. 113: 1281-1290, 1987.
  • 13. Kulan K, Komsuoglu B, Tuncer C, Kulan C: Significance of QT dispersion on ventricular arrhythmias in mitral valve prolapse. Int J Cardiol. 54:251-257, 1996.
  • 14. Tieleman RG, Crijns HJ, Wiesfeld AC, Posma J, Hamer HP, Lie KI: Increased dispersion refractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Br Heart J. 73:37–40, 1995.
  • 15. Zouridakis EG, Parthenakis FI, Kochiadakis GE, Kanoupakis EM, Vardas PE: QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness. Europace3: 292-298, 2001.

İzole Mitral Kapak Prolapsusunda QT Degiskenleri

Year 2007, Volume: 9 Issue: 2, 19 - 24, 01.07.2007

Abstract

Amaç: Mitral Kapak prolapsusu (MKP) ile iliskili ani ölümlerden aritmilerin sorumlu oldugu düsünülmektedir. QT araligi ölçümü bu hastalardaki malign aritmi potansiyelini tahmin edebilir. Bu çalismanin amaci MKP hastalarinda QT degiskenlerini arastirmaktir. Gereç ve Yöntem: Romatizmal ve komplike olmayan izole MKP’lu 46 hasta ve 25 saglikli birey kontrol grubu olarak çalisildi. Çalismaya alinan tüm bireylere, M-mod, 2-boyutlu ve renkli Doppler ekokardiyografi uygulandi. MKP tanimi; sistol sirasinda mitral yaprakçiklarin en az 2 mm atriuma dogru bombelesmesi ve diastolde yaprakçik kalinliginin 5 mm üzerinde saptanmasi ile kondu. Ayrica her hastada maksimum (QTmax), minimum (QTmin), düzeltilmis QT (QTc) ve QT dispersiyonu hesaplandi. MKP hastalarinin sonuçlari kontrol grubu ile karsilastirildi. Bulgular: Hastalarin demografik ve klinik verileri kontrol grubu ile benzerdi. Hastalarin anterior mitral yaprakçik kalinligi (AMYK), maksimum yaprakçik kaymasi (MYK) ve mitral yetersizlik orani (MYO) kontrol grubundan anlamli derecede yüksekti. Yine, QTc max, QTd ve düzeltilmis QTcD hasta grubunda anlamli derecede yüksek bulundu. QTc max ve QTcD ile ekokardiyografik parametrelerden AMYK, MYK ve MYO arasinda anlamli ve oldukça güçlü korelasyon saptandi. Sonuç: Izole MVP’li hastalarda QT araligi anlamli derecede uzamaktadir. Bu durum hasta grubunda yasanan artmis ventriküler aritmi ve ani ölüm sikligini açiklayabilir. Dahasi, QT degiskenleri mitral yaprakçigin kalinligi ve mitral yetersizlik derecesi ile, dolayisi ile MKP’nun agirligi ile iliskilidir

References

  • 1. Dören DR, Becker AE, Dunning AS: Long term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. J Am Coll Cardiol. 11:42–47, 1988.
  • 2. Kligfield P, Devereux RB: Arrhythmias in mitral valve prolapse. Clin Prog Electrophysiol Pacing. 3:403-418, 1985.
  • 3. Sanfilippo AJ, Abdollah H, Burggraf GW: Quantification and significance of systolic mitral leaflet displacement in mitral valve prolapse. Am J Cardiol. 64:1349-1355, 1989.
  • 4. Bekheit SG, Ali AA, Deglin SM, Jain AC: Analysis of QT interval in patients with idiopathic mitral valve prolapse. Chest. 81: 620–625, 1982.
  • 5. Puddu PE, Pasternac A, Tubau JF, Krol R, Farley L, de Champlain J: QT interval prolongation and increased plasma catecholamine levels in patients with mitral valve prolapse. Am Heart J. 105: 422–428, 1983.
  • 6. Henry WL, DeMaria A, Gramiak R King DL, Kisslo JA, Popp RL, Sahn DJ, Schiller NB, Tajik A, Teichholz LE, Weyman AE: Report of the American Society of Echocardiography Comitee on Nomenclature and Standarts in two dimensional imaging. Circulation. 62: 212-217, 1980.
  • 7. Freed LA, Levy D, Levine RA, Larson MG, Evans JC, Fuller DL, Lehman B, Benjamin EJ: Prevalance and clinical outcome of mitralvalve prolapse. New Eng J Med. 341: 1-7, 1999.
  • 8. Devereux RB. Reichek N: Echocardiographic determinationation of left ventricular mass in mann: Comparison to necropsy findings. Circulation. 55: 613-617, 1977.
  • 9. DuBois D, DuBois EF: Clinical calorimetry: A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 17: 863-871, 1916.
  • 10. Kligfield P, Levy D, Devereux RB, Savage DD: Arrhythmias and sudden death in mitral valve prolapse. Am Heart J. 113:1298-1307, 1987.
  • 11. Ulgen MS, Biyik I, Karadede A, Temamogullari AV, Alan S, Toprak N: Relation between QT dispersion and ventricular arrhythmias in uncomplicated isolated mitral valve prolapse. Jpn Circ J. 63: 929-933, 1999.
  • 12. Levy D, Savage D: Prevalence and clinical features of mitral valve prolapse. Am Heart J. 113: 1281-1290, 1987.
  • 13. Kulan K, Komsuoglu B, Tuncer C, Kulan C: Significance of QT dispersion on ventricular arrhythmias in mitral valve prolapse. Int J Cardiol. 54:251-257, 1996.
  • 14. Tieleman RG, Crijns HJ, Wiesfeld AC, Posma J, Hamer HP, Lie KI: Increased dispersion refractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Br Heart J. 73:37–40, 1995.
  • 15. Zouridakis EG, Parthenakis FI, Kochiadakis GE, Kanoupakis EM, Vardas PE: QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness. Europace3: 292-298, 2001.
There are 15 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Sinan Albayrak This is me

Serkan Bulur This is me

Yakup Balaban This is me

Aytekin Alçelık This is me

Ugur Korkmaz Korkmaz This is me

Mehmet Yazıcı This is me

Hakan Özhan This is me

Publication Date July 1, 2007
Published in Issue Year 2007 Volume: 9 Issue: 2

Cite

APA Albayrak, S., Bulur, S., Balaban, Y., Alçelık, A., et al. (2007). QT Variables of Isolated Mitral Valve Prolapse. Duzce Medical Journal, 9(2), 19-24.
AMA Albayrak S, Bulur S, Balaban Y, Alçelık A, Korkmaz UK, Yazıcı M, Özhan H. QT Variables of Isolated Mitral Valve Prolapse. Duzce Med J. July 2007;9(2):19-24.
Chicago Albayrak, Sinan, Serkan Bulur, Yakup Balaban, Aytekin Alçelık, Ugur Korkmaz Korkmaz, Mehmet Yazıcı, and Hakan Özhan. “QT Variables of Isolated Mitral Valve Prolapse”. Duzce Medical Journal 9, no. 2 (July 2007): 19-24.
EndNote Albayrak S, Bulur S, Balaban Y, Alçelık A, Korkmaz UK, Yazıcı M, Özhan H (July 1, 2007) QT Variables of Isolated Mitral Valve Prolapse. Duzce Medical Journal 9 2 19–24.
IEEE S. Albayrak, S. Bulur, Y. Balaban, A. Alçelık, U. K. Korkmaz, M. Yazıcı, and H. Özhan, “QT Variables of Isolated Mitral Valve Prolapse”, Duzce Med J, vol. 9, no. 2, pp. 19–24, 2007.
ISNAD Albayrak, Sinan et al. “QT Variables of Isolated Mitral Valve Prolapse”. Duzce Medical Journal 9/2 (July 2007), 19-24.
JAMA Albayrak S, Bulur S, Balaban Y, Alçelık A, Korkmaz UK, Yazıcı M, Özhan H. QT Variables of Isolated Mitral Valve Prolapse. Duzce Med J. 2007;9:19–24.
MLA Albayrak, Sinan et al. “QT Variables of Isolated Mitral Valve Prolapse”. Duzce Medical Journal, vol. 9, no. 2, 2007, pp. 19-24.
Vancouver Albayrak S, Bulur S, Balaban Y, Alçelık A, Korkmaz UK, Yazıcı M, Özhan H. QT Variables of Isolated Mitral Valve Prolapse. Duzce Med J. 2007;9(2):19-24.