Mitral annular disjunction in out-of-hospital cardiac arrest patients-a retrospective cardiac MRI study.
Clin Res Cardiol
; 113(5): 770-780, 2024 May.
Article
in En
| MEDLINE
| ID: mdl-38602567
ABSTRACT
BACKGROUND:
Mitral annular disjunction (MAD), defined as defective attachment of the mitral annulus to the ventricular myocardium, has recently been linked to malignant arrhythmias. However, its role and prognostic significance in patients requiring cardiopulmonary resuscitation (CPR) remain unknown. This retrospective analysis aimed to describe the prevalence and significance of MAD by cardiac magnetic resonance (CMR) imaging in out-of-hospital cardiac arrest (OHCA) patients.METHODS:
Eighty-six patients with OHCA and a CMR scan 5 days after CPR (interquartile range (IQR) 49 days before - 9 days after) were included. MAD was defined as disjunction-extent ≥ 1 mm in CMR long-axis cine-images. Medical records were screened for laboratory parameters, comorbidities, and a history of arrhythmia.RESULTS:
In 34 patients (40%), no underlying cause for OHCA was found during hospitalization despite profound diagnostics. Unknown-cause OHCA patients showed a higher prevalence of MAD compared to definite-cause patients (56% vs. 10%, p < 0.001) and had a MAD-extent of 6.3 mm (IQR 4.4-10.3); moreover, these patients were significantly younger (43 years vs. 61 years, p < 0.001), more often female (74% vs. 21%, p < 0.001) and had fewer comorbidities (hypertension, hypercholesterolemia, coronary artery disease, all p < 0.005). By logistic regression analysis, the presence of MAD remained significantly associated with OHCA of unknown cause (odds ratio 8.49, 95% confidence interval 2.37-30.41, p = 0.001) after adjustment for age, presence of hypertension, and hypercholesterolemia.CONCLUSIONS:
MAD is rather common in OHCA patients without definitive aetiology undergoing CMR. The presence of MAD was independently associated to OHCA without an identifiable trigger. Further research is needed to understand the exact role of MAD in OHCA patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Out-of-Hospital Cardiac Arrest
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Hypercholesterolemia
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Hypertension
Limits:
Female
/
Humans
Language:
En
Journal:
Clin Res Cardiol
Journal subject:
CARDIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Austria
Country of publication:
Alemania