Multiparametric SCores for Prediction of Myocardial fIbrosis in Patients With MITral vAlve pRolapse: the SCIMITAR Trial
Overview
- Phase
- Not Applicable
- Intervention
- Prospective Cohort
- Conditions
- Mitral Valve Prolapse
- Sponsor
- Centro Cardiologico Monzino
- Enrollment
- 300
- Locations
- 1
- Primary Endpoint
- Prediction of fibrosis by CMR
- Status
- Recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
This is a multicenter, observational prospective and retrospective study which aims are: 1) to compute a scoring model potentially predictive for the diagnosis of fibrosis by CMR in patients with MVP; 2) to identify specific features that may predispose to ≥ mild VAs or SCD in patients with MVP.
Detailed Description
Patients with mitral valve prolapse and non-significant mitral regurgitation generally have a good prognosis. A minority of patients with MVP suffers from ventricular arrhythmias. Different demographic, clinical, and electrocardiographic characteristics, as well as morphological and structural features of the MV were described as potential risk factors for ventricular arrhythmias, among which fibrosis of the left ventricular inferolateral wall and posterior papillary muscle as detected by cardiac magnetic resonance. As cardiac magnetic resonance has some limitations, it is unknown if and which patients with mitral valve prolapse should undergo cardiac magnetic resonance in routine clinical practice, to search for late gadolinium enhancement as a surrogate for myocardial fibrosis.
Investigators
Eligibility Criteria
Inclusion Criteria
- •age ≥ 18 years
- •Echocardiographic diagnosis of mitral valve prolaspe, defined as a systolic displacement of one or both mitral leaflets ≥ 2 mm above the plane of the mitral valve annulus in long-axis views
Exclusion Criteria
- •age\< 18 years
- •coexistence of other cardiomyopathies or other ≥ moderate valve diseases
- •scarce acoustic transthoracic echocardiographic window
- •usual contraindications for cardiac magnetic resonance
Arms & Interventions
Prospective Cohort
Prospectively enrolled patients will undergo a complete assessment, as clinically indicated, including clinical evaluation, TTE, rest ECG, 24h ECG-monitoring, and CMR. CMR will be performed no more than 6 months apart from other examinations (TTE, rest ECG, 24h ECG-monitoring).
Retrospective Cohort
Patients will be enrolled retrospectively, in case they have already performed all examinations between 2016 and 2023
Outcomes
Primary Outcomes
Prediction of fibrosis by CMR
Time Frame: June 2026
Clinical, echocardiographic, electrocardiographic, and 24h-ECG monitoring variables will be collected in order to identify potential predictors of fibrosis as detected by cardiac magnetic resonance (CMR). Specifically, the following parameters will be collected. * Clinical data: * Transthoracic echocardiography parameters: * Rest ECG parameters: * 24h electrocardiographic monitoring parameters: * Ventricular arrhythmias (VAs) will be classified as suggested in the recently published EHRA consensus statement * CMR parameters, applying the protocol of the Society of Cardiovascular Magnetic Resonance
Secondary Outcomes
- Prediction of ≥ mild Ventricular Arrhythmias and/or Sudden cardiac death in mitral valve(June 2026)
- Clinical data(June 2026)
- Transthoracic echocardiography parameters:(June 2026)
- Rest ECG parameters:(June 2026)
- 24h electrocardiographic monitoring parameters:(June 2026)
- CMR parameters(June 2026)