Mitral annulus disjunction: is it a marker of ominous prognosis?

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Mitral annulus disjunction (MAD) has been proposed as a contributing factor for arrythmias and mitral regurgitation in patients with valve prolapse (MVP), however its clinical relevance is still under investigation. Objective To evaluate the frequency MAD MVP patients, to characterize clinically assess potential markers events. Methods Single-center retrospective study consecutive documented transthoracic echocardiogram between January 2014 October 2019. was defined according 2017 AHA recommendations; separation left ventricle free wall. Demographic, clinical, echocardiographic, electrocardiographic data were collected. The results obtained using Chi-square Mann-Whitney tests; logistic regression used find predictors Results 247 included (mean age 62.9 ± 18 years, 61% males), these 23 (9.3%) had 56 20 56.5% males). maximum diameter 10 3mm (range 5-18). 21 (92.3%) regurgitation, it at least moderate severity 65.2% patients. Most (91.3, n = 21) sinus rhythm (SR). During follow-up (FUP) 29 19 months, 39% (n 9) developed symptoms, 22% 5) atrial fibrillation (AF), 4.3% 1) acute aortic syndrome (AAS), needed ICD, submitted intervention, 8.7% 2) admitted hospital died. None presented sustained ventricular arrhythmias (SVA) assessed regular Holter monitoring. These more AAS ICD FUP compared without (p 0.007 p 0.006, respectively) cord rupture 0.04), 0.044), velocity tricuspid 0.04) IVS thickness 0.017) associated AF univariate analysis, interventricular septum predictor this subgroup (OR 4.0, 95%CI 1.1-14.3, 0-032) presence SR survival 0.03). There no admission or intervention. Conclusion Patients relatively benign prognosis few events during follow-up, although FUP. In our sample, common than SVA. Left hypertrophy survival. Larger studies other methods imaging are confirm results.