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Folks with a sure coronary heart valve abnormality are at elevated danger of extreme coronary heart rhythm issues, even after profitable valve surgical procedure. That is in keeping with a brand new research, “Mitral annular disjunction and mitral valve prolapse: long-term risk of ventricular arrhythmias after surgery” from Karolinska Institutet and Karolinska College Hospital in Sweden, printed within the European Coronary heart Journal.
The situation is extra widespread in girls and youthful sufferers with valve dysfunction and may, within the worst case, result in sudden cardiac arrest.
Mitral annular disjunction, MAD, is a coronary heart abnormality by which the mitral valve attachment “slides.” Lately, the situation has been linked to an elevated danger of extreme cardiac arrhythmias. Till now, it has not been recognized whether or not the chance of arrhythmias disappears if MAD is surgically corrected.
MAD is commonly related to a coronary heart illness referred to as mitral valve prolapse, which impacts 2.5% of the inhabitants and causes one of many coronary heart’s valves to leak. This may result in blood being pumped backward within the coronary heart, inflicting coronary heart failure and arrhythmias. The illness could cause signs resembling shortness of breath and palpitations.
Following sufferers after surgical procedure
Within the present research, researchers at Karolinska Institutet investigated the chance of cardiac arrhythmias in 599 sufferers with mitral valve prolapse who underwent coronary heart surgical procedure at Karolinska College Hospital between 2010 and 2022. Some 16% of the sufferers additionally had the cardiac abnormality MAD.
“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 rhythm disorder that, in the worst case, can lead to cardiac arrest in a subset of patients,” says Bahira Shahim, affiliate professor on the Division of Drugs, Solna, Karolinska Institutet and heart specialist at Karolinska College Hospital.
Folks with MAD have been extra more likely to be feminine and have been on common eight years youthful than these with out MAD. Additionally they had extra in depth mitral valve illness. Though the surgical procedure was profitable in correcting MAD, these sufferers had greater than 3 times the chance of ventricular arrhythmias throughout 5 years of follow-up in comparison with sufferers with out preoperative MAD.
“Our results show that it is important to closely monitor patients with this condition, even after a successful operation,” says Bahira Shahim.
Investigating a number of hypotheses
The research has led to new hypotheses that the researchers are actually investigating additional. One speculation is that MAD causes everlasting modifications within the coronary heart muscle over time. One other is that MAD is an indication of an underlying coronary heart muscle illness.
The researchers are actually persevering with to check scarring within the coronary heart utilizing MRI (magnetic resonance imaging) and analyze tissue samples from the center muscle.
The analysis was led by heart specialist and affiliate professor Bahira Shahim in shut collaboration with Magnus Dalén, affiliate professor at Karolinska Institutet and cardiac surgeon at Karolinska College Hospital, and Klara Lodin, Ph.D. pupil at Karolinska Institutet.
Extra info:
Bahira Shahim et al, Mitral annular disjunction and mitral valve prolapse: long-term danger of ventricular arrhythmias after surgical procedure, (2025). DOI: 10.1093/eurheartj/ehaf195
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