Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22918
Title: Characteristic Histopathological Findings and Cardiac Arrest Rhythm in Isolated Mitral Valve Prolapse and Sudden Cardiac Death.
Authors: Han, Hui-Chen;Parsons, Sarah A;Teh, Andrew W;Sanders, Prashanthan;Neil, Christopher;Leong, Trishe;Koshy, Anoop N;Vohra, Jitendra K;Kalman, Jonathan M;Smith, Karen;O'Donnell, David;Hare, David L;Farouque, Omar;Lim, Han S
Affiliation: Department of Forensic Medicine Victorian Institute of Forensic Medicine and Monash University Melbourne Victoria Australia
Department of Anatomical Pathology, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiology Western Health and University of Melbourne Melbourne Victoria Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Centre for Heart Rhythm Disorders South Australian Health and Medical Research Institute University of Adelaide and Royal Adelaide Hospital Melbourne South Australia Australia
University of Melbourne Melbourne Victoria Australia
Department of Cardiology Eastern Health and Monash University Melbourne Victoria Australia
Department of Cardiology Northern Health and University of Melbourne Melbourne Victoria Australia
Centre for Research and Evaluation Ambulance Victoria and Monash University Melbourne Victoria Australia
Department of Cardiology Royal Melbourne Hospital and University of Melbourne Melbourne Victoria Australia
Department of Cardiology and Department of Genomics Royal Melbourne Hospital and University of Melbourne Melbourne Victoria Australia
Issue Date: 7-Apr-2020
EDate: 2020-04-07
Citation: Journal of the American Heart Association 2020; 9(7): e015587
Abstract: Background The association between mitral valve prolapse (MVP) and sudden death remains controversial. We aimed to describe histopathological changes in individuals with autopsy-determined isolated MVP (iMVP) and sudden death and document cardiac arrest rhythm. Methods and Results The Australian National Coronial Information System database was used to identify cases of iMVP between 2000 and 2018. Histopathological changes in iMVP and sudden death were compared with 2 control cohorts matched for age, sex, height, and weight (1 group with noncardiac death and 1 group with cardiac death). Data linkage with ambulance services provided cardiac arrest rhythm for iMVP cases. From 77 221 cardiovascular deaths in the National Coronial Information System database, there were 376 cases with MVP. Individual case review yielded 71 cases of iMVP. Mean age was 49±18 years, and 51% were women. Individuals with iMVP had higher cardiac mass (447 g versus 355 g; P<0.001) compared with noncardiac death, but similar cardiac mass (447 g versus 438 g; P=0.64) compared with cardiac death. Individuals with iMVP had larger mitral valve annulus compared with noncardiac death (121 versus 108 mm; P<0.001) and cardiac death (121 versus 110 mm; P=0.002), and more left ventricular fibrosis (79% versus 38%; P<0.001) compared with noncardiac death controls. In those with iMVP and witnessed cardiac arrest, 94% had ventricular fibrillation. Conclusions Individuals with iMVP and sudden death have increased cardiac mass, mitral annulus size, and left ventricular fibrosis compared with a matched cohort, with cardiac arrest caused by ventricular fibrillation. The histopathological changes in iMVP may provide the substrate necessary for development of malignant ventricular arrhythmias.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22918
DOI: 10.1161/JAHA.119.015587
ORCID: 0000-0002-8741-8631
0000-0001-9554-6556
PubMed URL: 32233752
Type: Journal Article
Subjects: sudden death
valvular heart disease
ventricular arrhythmia
Appears in Collections:Journal articles

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