Original Article

Assessment of Transmural Dispersion of Repolarization in Children with Mitral Valve Prolapse

Abstract

Background: Children with mitral valve prolapse (MVP) may be prone to ventricular arrhythmias due to transmural dispersion of repolarization (TDR). This study aimed to assess alterations in ventricular repolarization in children with MVP and to investigate their relationships with the degree of mitral regurgitation.
Methods: Fifty children with MVP and 50 age- and sex-matched healthy children as controls were studied. Twelve-lead electrocardiography and echocardiography were performed in all the subjects. TDR parameters were QT and QTc intervals, QTc dispersion, Tp-e interval, Tp-e interval dispersion, Tp-e/QT, Tp-e/QTc, JTc, JTc dispersion, Tp-e/JT, and Tp-e/JTc.
Results: The mean age of the 50 patients with MVP was 12.45±2.50 years (F/M: 15/35). There were no significant differences in QT and QTc intervals between the 2 groups. QTc dispersion (P=0.001), Tp-e dispersion interval (P=0.002), Tp-e/QTc (P=0.001), JTc dispersion (P=0.023), Tp-e/JT (P=0.004), and Tp-e/JTc (P=0.002) were significantly higher in the patients with MVP than in the healthy controls. Positive correlations were found between Tp-e dispersion interval and Tp-e/QTc and an increase in the degree of mitral regurgitation (P=0.012, r=0.42 and P=0.004, r=0.31, respectively). Additionally, positive correlations were detected between JTc dispersion and Tp-e/JTc and an increase in the degree of mitral regurgitation (P=0.032, r=0.20 and P=0.024, r=0.42, correspondingly).
Conclusion: In this study, TDR was damaged in children with MVP and was positively correlated with an increase in the degree of mitral regurgitation. It appears that children with MVP are prone to life-threatening ventricular arrhythmias.

Devereux RB, Jones EC, Roman MJ, Howard BV, Fabsitz RR, Liu JE, Palmieri V, Welty TK, Lee ET. Prevalence and correlates of mitral valve prolapse in a population-based sample of American Indians: the Strong Heart Study. Am J Med 2001;111:679-685.
2. Nishimura RA, McGoon MD, Shub C, Miller FA, Jr, Ilstrup DM, Tajik AJ. Echocardiographically documented mitral-valve prolapse. Long-term follow-up of 237 patients. N Engl J Med 1985;313:1305-1309.
3. Freed LA, Benjamin EJ, Levy D, Larson MG, Evans JC, Fuller DL, Lehman B, Levine RA. Mitral valve prolapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol 2002;40:1298-1304.
4. Plicht B, Rechenberg W, Kahlert P, Buck T, Erbel R. Mitral valve prolapse: identification of high-risk patients and therapeutic management. Herz 2006;31:14-21.
5. Kligfield P, Levy D, Devereux RB, Savage DD. Arrhythmias and sudden death in mitral valve prolapse. Am Heart J 1987;113:1298-1307.
6. Kulan K, Komsuoğlu B, Tuncer C, Kulan C. Significance of QT dispersion on ventricular arrhythmias in mitral valve prolapse. Int J Cardiol 1996;54:251-257.
7. Yontar OC, Karaagac K, Tenekecioglu E, Tutuncu A, Demir M, Melek M. Assessment of ventricular repolarization inhomogeneity in patients with mitral valve prolapse: value of T wave peak to end interval. Int J Clin Exp Med 2014;7:2173-2178.
8. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41:575-580.
9. Demirol M, Karadeniz C, Ozdemir R, Çoban Ş, Katipoğlu N, Yozgat Y, Meşe T, Unal N. Prolonged Tp-e interval and Tp-e/QT ratio in children with mitral valve prolapse. Pediatr Cardiol 2016;37:1169-1174.
10. Digeos-Hasnier S, Copie X, Paziaud O, Abergel E, Guize L, Diebold B, Jeunemaître X, Berrebi A, Piot O, Lavergne T, Le Heuzey JY. Abnormalities of ventricular repolarization in mitral valve prolapse. Ann Noninvasive Electrocardiol 2005;10:297-304.
11. Zouridakis EG, Parthenakis FI, Kochiadakis GE, Kanoupakis EM, Vardas PE. QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness. Europace 2001;3:292-298.
12. Panikkath R, Reinier K, Uy-Evanado A, Teodorescu C, Hattenhauer J, Mariani R, Gunson K, Jui J, Chugh SS. Prolonged Tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol 2011;4:441-447.
Files
IssueVol 15 No 2 (2020): J Teh Univ Heart Ctr QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jthc.v15i2.4185
Keywords
Arrhythmias; cardiac Child Mitral valve prolapse

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ghandi Y, Ghahremani B, Habibi D, Pouya A, Sadrnia S. Assessment of Transmural Dispersion of Repolarization in Children with Mitral Valve Prolapse. J Tehran Heart Cent. 2020;15(2):64-68.