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Heart Valve Abnormality Linked to Increased Risk of Arrhythmias Post-Surgery
A recent study from Karolinska Institutet and Karolinska University Hospital in Sweden reveals that individuals with a specific heart valve abnormality are at a heightened risk for severe heart rhythm disorders, even after undergoing successful surgical procedures. Published in the European Heart Journal, this research highlights a concerning trend particularly prevalent among women and younger individuals suffering from valve disorders, which may, in extreme cases, lead to sudden cardiac arrest.
Mitral annular disjunction (MAD) is characterized by the abnormal sliding of the mitral valve attachment. Recent findings have established a correlation between MAD and a significant risk for severe cardiac arrhythmias. However, previous discussions lacked clarity on whether surgical correction of MAD effectively mitigates the risk of these arrhythmias.
MAD often occurs alongside mitral valve prolapse, a common heart disorder affecting approximately 2.5 percent of the general population. This condition leads to leakage in one of the heart’s valves, resulting in retrograde blood flow that can precipitate heart failure and arrhythmias. Symptoms associated with this disease commonly include shortness of breath and palpitations.
Study Overview
In their investigation, the researchers analyzed a cohort of 599 patients with mitral valve prolapse who had undergone heart surgery at Karolinska University Hospital from 2010 to 2022. Among these, 16 percent were identified as having MAD.
According to Bahira Shahim, an associate professor and cardiologist at Karolinska University Hospital, “Our findings indicate that individuals with MAD face a significantly elevated risk of experiencing ventricular arrhythmias, a potentially life-threatening type of heart rhythm disorder that can lead to cardiac arrest in certain patients.” The data shows that patients with MAD were predominantly female and on average eight years younger than their counterparts without the abnormality, along with having more severe mitral valve disease.
Post-Surgery Risks
Despite successful surgical intervention for MAD, the risk of ventricular arrhythmias remained more than threefold higher during a five-year follow-up period for those with the abnormality compared to patients without preoperative MAD.
“Our results underscore the necessity for vigilant monitoring of patients diagnosed with MAD, even following operation success,” remarks Bahira Shahim.
Future Research Directions
The study has sparked intriguing hypotheses that researchers are examining as part of ongoing investigations. One theory suggests that MAD may instigate lasting changes in heart muscle tissue over time. Another possibility is that MAD itself could indicate an underlying heart muscle disease. To explore these avenues, the researchers plan to utilize magnetic resonance imaging (MRI) to study heart scarring and conduct analyses on tissue samples from affected heart muscle.
The research project was spearheaded by cardiologist Bahira Shahim, in partnership with Magnus Dalén, a cardiac surgeon and associate professor at Karolinska Institutet, and Klara Lodin, a PhD student at the same institute. Funding for the study was provided by various organizations, including ALF funds, the Swedish Heart-Lung Foundation, the Swedish Research Council, the Swedish Society for Medical Research, the Swedish Society of Medicine, and Karolinska Institutet.
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