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Mitral valve prolapse (MVP) and mitral annular disjunction (MAD) are structural abnormalities associated with life-threatening ventricular arrhythmias, known as arrhythmic mitral valve syndrome (AMVS). Clinically, MAD and MVP have been observed to often coincide with left ventricular (LV) remodeling, hypothesized to be linked to arrhythmogenesis. However, the complex geometric variations of the LV in MAD/MVP remain poorly understood, and traditional clinical metrics often do not fully capture nor quantify these. In this study, we use statistical shape modeling to quantify LV geometrical variation in MAD/MVP and investigate its association with arrhythmia. Using cardiac magnetic resonance (CMR) imaging data, we derived three-dimensional (3D) shape features to comprehensively quantify LV morphological variation in a clinical cohort. Our analysis found an LV shape mode significantly associated with arrhythmic events, aligning with the clinically-suggested role for MAD/MVP-induced LV structural remodeling in AMVS-related arrhythmogenesis. These findings suggest that 3D LV geometry shape analysis may provide novel biomarkers for arrhythmic risk, paving the way for improved risk stratification in patients with AMVS.

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Arrhythmic Mitral Valve Syndrome: Insights from Left Ventricular End-Systolic Shape Analysis

  • 会议论文

  • 发表日期：

    2025年

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  • Giulia Monopoli,
  • Mohammad Javad Sadeghinia,
  • Eivind Westrum Aabel,
  • Margareth Ribe,
  • Anna Isotta Castrini,
  • Nina Hasselberg,
  • Cecilie Bugge,
  • Christian Five,
  • Kristina Haugaa,
  • Gabriel Balaban,
  • Nickolas Forsch,
  • Mary M. Maleckar

摘要

Mitral valve prolapse (MVP) and mitral annular disjunction (MAD) are structural abnormalities associated with life-threatening ventricular arrhythmias, known as arrhythmic mitral valve syndrome (AMVS). Clinically, MAD and MVP have been observed to often coincide with left ventricular (LV) remodeling, hypothesized to be linked to arrhythmogenesis. However, the complex geometric variations of the LV in MAD/MVP remain poorly understood, and traditional clinical metrics often do not fully capture nor quantify these. In this study, we use statistical shape modeling to quantify LV geometrical variation in MAD/MVP and investigate its association with arrhythmia. Using cardiac magnetic resonance (CMR) imaging data, we derived three-dimensional (3D) shape features to comprehensively quantify LV morphological variation in a clinical cohort. Our analysis found an LV shape mode significantly associated with arrhythmic events, aligning with the clinically-suggested role for MAD/MVP-induced LV structural remodeling in AMVS-related arrhythmogenesis. These findings suggest that 3D LV geometry shape analysis may provide novel biomarkers for arrhythmic risk, paving the way for improved risk stratification in patients with AMVS.