二尖瓣脱垂患者心脏磁共振晚期钆增强与室性心律失常之间的关系：系统回顾与元分析》。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-07-03 DOI:10.1002/clc.24316

Xiaofu Tang, Weiguo Fan

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摘要

导言：据报道，二尖瓣脱垂（MVP）患者会出现恶性室性心律失常（VA）和心脏性猝死（SCD）；然而，目前仍缺乏有效的风险分层方法。心肌纤维化被认为在 VA 的发生中起着重要作用；然而，观察性研究就 MVP 患者 VA 与晚期钆增强（LGE）之间的关系得出了相互矛盾的结论。本观察性研究的荟萃分析和系统回顾旨在研究 MVP 患者左心室 LGE 与 VA 之间的关系：我们检索了1993年至2023年的PubMed、Embase和Web of Science数据库，以确定比较有左室LGE和无左室LGE的MVP患者VA发生率的病例对照、横断面和队列研究：共有 12 项观察性研究中的 1464 名 MVP 患者符合资格标准。其中有 221 人（15.1%）报告了 VA 发作。元分析表明，左心室 LGE 的存在与 VA 风险的增加显著相关（汇总风险比 2.96，95% CI：2.26-3.88，异质性 p = 0.07，I2 = 40%）。然而，对二尖瓣反流（MR）患病率的元回归分析表明，MR的严重程度对LGE的发生与VA之间的关系没有显著影响（P = 0.079）：结论：LGE 的检测有助于对 MVP 患者的 VA 风险进行分层。

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The Association Between Late Gadolinium Enhancement by Cardiac Magnetic Resonance and Ventricular Arrhythmia in Patients With Mitral Valve Prolapse: A Systematic Review and Meta-Analysis

Introduction

Malignant ventricular arrhythmia (VA) and sudden cardiac death (SCD) have been reported in patients with mitral valve prolapse (MVP); however, effective risk stratification methods are still lacking. Myocardial fibrosis is thought to play an important role in the development of VA; however, observational studies have produced contradictory findings regarding the relationship between VA and late gadolinium enhancement (LGE) in MVP patients. The aim of this meta-analysis and systematic review of observational studies was to investigate the association between left ventricular LGE and VA in patients with MVP.

Methods

We searched the PubMed, Embase, and Web of Science databases from 1993 to 2023 to identify case–control, cross-sectional, and cohort studies that compared the incidence of VA in patients with MVP who had left ventricular LGE and those without left ventricular LGE.

Results

A total of 1464 subjects with MVP from 12 observational studies met the eligibility criteria. Among them, VA episodes were reported in 221 individuals (15.1%). Meta-analysis demonstrated that the presence of left ventricular LGE was significantly associated with an increased risk of VA (pooled risk ratio 2.96, 95% CI: 2.26−3.88, p for heterogeneity = 0.07, I² = 40%). However, a meta-regression analysis of the prevalence of mitral regurgitation (MR) showed that the severity of MR did not significantly affect the association between the occurrence of LGE and VA (p = 0.079).