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Mitral Annular Disjunction: Associated Pathologies and Clinical Consequences

Jonas Verbeke1, Anthony Demolder2, Julie De Backer2

  • 1Department of Cardiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. jdverbek.verbeke@ugent.be.

Current Cardiology Reports
|November 4, 2022
PubMed
Abstract

Insights

Mitral annular disjunction (MAD) is linked to sudden cardiac death (SCD) in mitral valve prolapse (MVP) patients. Diagnosis and management of MAD present challenges, with unclear mechanisms and therapeutic implications.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Cardiovascular Imaging

Background:

  • Mitral annular disjunction (MAD) is increasingly recognized for its association with sudden cardiac death (SCD).
  • The "arrhythmic" mitral valve prolapse (MVP) syndrome highlights the link between MAD and SCD.
  • MAD, even in isolation, is suggested to be associated with severe arrhythmias and SCD.

Purpose of the Study:

  • To provide a comprehensive overview of mitral annular disjunction (MAD).
  • To discuss the significant challenges encountered in diagnosing and managing MAD.
  • To explore the current understanding and future directions in MAD research.

Main Methods:

  • Review of current literature on mitral annular disjunction (MAD).
  • Analysis of diagnostic modalities for MAD, including echocardiography and cardiac MRI.
  • Discussion of clinical implications and management strategies for patients with MAD.

Main Results:

  • Lack of consensus exists regarding the definition of MAD.
  • Uncertainty surrounds the optimal imaging modality for MAD diagnosis.
  • The precise mechanisms linking MAD to SCD remain largely unexplored.

Conclusions:

  • MAD is a critical consideration in patients with MVP and unexplained SCD.
  • Standardized diagnostic criteria and imaging protocols for MAD are needed.
  • Further research is essential to elucidate the pathophysiology and refine therapeutic approaches for MAD.
Keywords:
Mitral annular disjunctionMitral regurgitationMitral valve prolapseSudden cardiac death

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