Abstract

Atrial arrhythmias are seen frequently in symptomatic patients with mitral valve prolapse (MVP). The purpose of our study was to evaluate whether the atrial electromechanical delay (AEMD) measured by tissue Doppler imaging (TDI) is prolonged in patients with MVP. A total of 40 patients with MVP (16 males/24 females, 33.4 ± 6.1 years), and 40 controls (18 males/22 females, 34.2 ± 4.2 years) were included in the study. Inter-AEMD and intra- AEMD were measured by TDI. P-wave dispersion (PWD) was calculated from the 12-lead electrocardiogram. Inter-AEMD and intra-AEMD were significantly longer in patients with MVP than in the controls (31.6 ± 12.1 vs 24.7 ± 5.4 ms, p = 0.001 and 8.1 ± 5.3 vs. 5.7 ± 1.9 ms, p = 0.008; respectively). PWD was significantly longer in patients with MVP than in the controls (41.3 ± 7.1 vs 34.7 ± 4.3 ms, p<0.0001). The left atrial (LA) diameter, anterior and posterior mitral leaflet thicknesses were significantly higher in patients with MVP than in the controls. (35.4 ± 3.0 vs 31.9 ± 3.0 mm, p<0.0001 and 3.6 ± 0.9 vs 2.8 ± 0.7 mm, p<0.0001 and 2.9 ± 0.7 vs 2.2 ± 0.4 mm p<0.0001; respectively). Inter-AEMD was positively correlated with PWD, mitral leaflet thickening and LA diameter. We showed that AEMD is significantly prolonged in patients with MVP, and speculated that this prolongation may reflect the increase of the risk of atrial arrhythmias in MVP subjects. 

Key words: Mitral valve prolapse, atrial electromechanical delay, P-wave dispersion.