Mitral valve prolapse (MVP) is a frequent affection of the mitral valve or its sub-valvular
apparatus with a prevalence of 2-3% in the general population. This valvular disease is
generally considered as benign, but may at term evolve toward mitral valve regurgitation of
various severity and/or arrhythmia.
Mitral valve prolapse is routinely diagnosed using transthoracic echocardiography and only
patients with significant mitral regurgitation will undergo subsequent examination (24-hour
external loop recording, exercise ECG, cardiac MRI) and a close follow-up.
External loop recording and exercise ECG have an interest in the identification of patients
presenting with arrhythmic complications, such as premature ventricular contractions, and in
the global evaluation of hemodynamic consequences of the mitral regurgitation.
More recently, detection of myocardial fibrosis among patients with MVP and severe
ventricular arrhythmia has been identified. Fibrosis could evolve independently of the
valvular regurgitation's severity and could be a substrate (myocardial scar) leading to
ventricular arrhythmia. However, no study has specifically characterized myocardial lesions
among patients with MVP and none, or not significant, mitral regurgitation. Using cardiac
magnetic resonance imaging (MRI), gold standard technique in myocardial imaging and
characterization, and echocardiography, particularly speckle-tracking imaging, identification
of static (fibrosis) and/or dynamic (ventricular systolic deformation patterns using
speckle-tracking strain) myocardial lesions.
Identification of patients with impaired deformation patterns, fibrosis or with premature
ventricular contractions may isolate a sub-group of patients with a higher risk of severe
ventricular arrhythmia for whom a closer follow-up could be justified.