Researchers solidify link between mitral valve prolapse, sudden cardiac death

Mitral valve prolapse (MVP)—a common condition that’s rarely serious—might boost heart patients’ risk for sudden cardiac death (SCD), researchers reported in the BMJ journal Heart this week.

“MVP is commonly observed as a benign finding,” lead researcher Rajiv Mahajan, MD, PhD, and colleagues from the Universities of Adelaide, Melbourne, New South Wales and Queensland, wrote. “However, the literature suggests that it may be associated with sudden cardiac death.”

That literature, though, is limited, Mahajan et al. said. Barring a handful of case studies, clinicians know little about the link between MVP and SCD, other than the fact that there is one.

Mahajan and his team conducted a meta-analysis of more than 7,600 studies in the English medical literature, eventually narrowing the pool to a total of 34 studies. They said their analysis would focus on the prevalence of MVP in the general population, prevalence of MVP in cases of SCD and unexplained SCD and identify any risk factors that might link the two.

According to the study’s results, 12 percent of victims of sudden cardiac deaths also suffered from mitral valve prolapse. MPV patients—who make up 1.2 percent of community populations—suffered from SCD 0.14 percent of the time. The researchers also identified several potential risk factors for sudden cardiac death, including bileaflet prolapse, ventricular fibrosis complex ventricular ectopy and ST-T wave abnormalities.

“The high prevalence of MVP in cohorts of unexplained SCD despite low population prevalence provides indirect evidence of an association of MVP with SCD,” the authors wrote. “The absolute number of people exposed to the risk of SCD is significant, although the incidence of life-threatening arrhythmic events in the general MVP population remains low.”

Mahajan and colleagues said their next steps involve creating a prospective registry in Australia for patients with mitral valve prolapse, resuscitated cardiac arrest and SCD.

Prash Sanders, a co-author on the paper and director of the Center for Heart Rhythm Disorders at the University of Adelaide, said in a release that his team’s work is a “prime example” of how cross-institutional collaboration can result in improved patient outcomes.

“With one in five sudden cardiac deaths occurring in people with otherwise normal hearts, this research provides insight into the need for further investigation of patients with mitral valve prolapse and high-risk conditions for serious and life-threatening cardiac arrhythmias,” he said.