{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:41:18Z","timestamp":1792158078916,"version":"4.4.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2015,8,18]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Mitral valve prolapse (MVP) may present with ventricular arrhythmias and sudden cardiac death (SCD) even in the absence of hemodynamic impairment. The structural basis of ventricular electric instability remains elusive.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              The cardiac pathology registry of 650 young adults (\u226440 years of age) with SCD was reviewed, and cases with MVP as the only cause of SCD were re-examined. Forty-three patients with MVP (26 females; age range, 19\u201340 years; median, 32 years) were identified (7% of all SCD, 13% of women). Among 12 cases with available ECG, 10 (83%) had inverted T waves on inferior leads, and all had right bundle-branch block ventricular arrhythmias. A bileaflet involvement was found in 70%. Left ventricular fibrosis was detected at histology at the level of papillary muscles in all patients, and inferobasal wall in 88%. Living patients with MVP with (n=30) and without (control subjects; n=14) complex ventricular arrhythmias underwent a study protocol including contrast-enhanced cardiac magnetic resonance. Patients with either right bundle-branch block type or polymorphic complex ventricular arrhythmias (22 females; age range, 28\u201343 years; median, 41 years), showed a bileaflet involvement in 70% of cases. Left ventricular late enhancement was identified by contrast-enhanced cardiac magnetic resonance in 93% of patients versus 14% of control subjects (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), with a regional distribution overlapping the histopathology findings in SCD cases.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>MVP is an underestimated cause of arrhythmic SCD, mostly in young adult women. Fibrosis of the papillary muscles and inferobasal left ventricular wall, suggesting a myocardial stretch by the prolapsing leaflet, is the structural hallmark and correlates with ventricular arrhythmias origin. Contrast-enhanced cardiac magnetic resonance may help to identify in vivo this concealed substrate for risk stratification.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.115.016291","type":"journal-article","created":{"date-parts":[[2015,8,17]],"date-time":"2015-08-17T20:20:05Z","timestamp":1439842805000},"page":"556-566","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":576,"title":["Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death"],"prefix":"10.1161","volume":"132","author":[{"given":"Cristina","family":"Basso","sequence":"first","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Perazzolo Marra","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Rizzo","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"De Lazzari","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Giorgi","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Cipriani","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Chiara","family":"Frigo","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Rigato","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Migliore","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalliopi","family":"Pilichou","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Bertaglia","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Cacciavillani","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Bauce","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Corrado","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. F.M., K.P., E.B., L.C., B.B., D.C., G.T., S.I.) and Radiology (B.G.), Azienda Ospedaliera-University of Padua Medical School, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Thiene","sequence":"additional","affiliation":[{"name":"From Departments of Cardiac, Thoracic, and Vascular Sciences (C.B., M.P.M., S.R., M.D.L., A.C., A.C.F., I.R. 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