{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:40:27Z","timestamp":1790887227460,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Mitral valve prolapse (MVP) is among the most frequently diagnosed valvular heart diseases, with the majority of patients being asymptomatic. However, MVP may also present with ventricular arrhythmias (VA) or sudden cardiac death (SCD). The arrhythmic form of MVP and the complicated course of this condition are closely associated with mitral annular disjunction (MAD). MAD alters the anatomical integrity of the mitral annulus and is thought to contribute to leaflet degeneration and myocardial fibrosis, creating a substrate for malignant arrhythmias. The most common complications associated with MVP and MAD include progressive mitral valve regurgitation, left ventricular hypertrophy and an increased risk of SCD. Cardiac magnetic resonance (CMR) imaging is the most sensitive modality for detecting MAD and myocardial fibrosis and is thus essential for early diagnosis and risk stratification. This review aims to enhance recognition of MAD, summarize current diagnostic and risk assessment strategies, and provide clinical context through two cases of patients with arrhythmic MVP and MAD.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1698603","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T13:52:31Z","timestamp":1763992351000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Arrhythmogenic mitral valve prolapse and mitral annular disjunction: a literature review and case-based perspective"],"prefix":"10.3389","volume":"12","author":[{"given":"Aust\u0117","family":"Markevi\u010di\u016bt\u0117","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Kmitait\u0117","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audron\u0117","family":"Vaitiekien\u0117","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Rink\u016bnien\u0117","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2719","DOI":"10.1038\/s41598-021-81648-z","article-title":"Prevalence and characteristics of mitral valve prolapse in military young adults in Taiwan of the CHIEF heart study","volume":"11","author":"Liu","year":"2021","journal-title":"Sci Rep"},{"key":"B2","volume-title":"Mitral Valve Prolapse","author":"Shah","year":"2023"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1130174","DOI":"10.3389\/fcvm.2023.1130174","article-title":"Arrhythmic mitral valve prolapse in 2023: evidence-based update","volume":"10","author":"Kubala","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"976066","DOI":"10.3389\/fcvm.2022.976066","article-title":"Mitral annular disjunction: a case series and review of the literature","volume":"9","author":"Wu","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1016\/j.hrthm.2024.05.049","article-title":"Prevalence and predictors of mitral annular disjunction and ventricular ectopy in mitral valve prolapse","volume":"21","author":"Cesmat","year":"2024","journal-title":"Heart Rhythm"},{"key":"B6","doi-asserted-by":"publisher","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur Heart J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s10554-020-01818-4","article-title":"Prevalence of mitral annular disjunction in patients with mitral valve prolapse and severe regurgitation","volume":"36","author":"Putnam","year":"2020","journal-title":"Int J Cardiovasc Imaging"},{"key":"B8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s44156-023-00032-x","article-title":"Mitral annular disjunction in surgical mitral valve prolapse: prevalence, characteristics and outcomes","volume":"10","author":"Gray","year":"2023","journal-title":"Echo Res Pract"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.15420\/aer.2021.28","article-title":"Arrhythmogenic mitral valve prolapse","volume":"11","author":"Korovesis","year":"2022","journal-title":"Arrhythm Electrophysiol Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"101298","DOI":"10.1016\/j.ijcha.2023.101298","article-title":"Mitral annular disjunction; how accurate are we? 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