Evaluation of left ventricular function in patients with mitral annular disjunction using speckle tracking echocardiography

Background Mitral annular disjunction (MAD) is a structural abnormality characterized by the systolic detachment of the posterior mitral annulus and the ventricular myocardium. It is usually observed coexistent with mitral valve prolapse (MVP) and associated with a mechanical dysfunction despite preserved electrical isolation function of the mitral annulus. This study aimed to evaluate left ventricular (LV) function using speckle tracking echocardiography in MVP patients with MAD. Methods This study was designed as a prospective, single‐center study including 103 patients with MVP and 40 age‐ and sex‐matched control subjects. Transthoracic echocardiography and cardiac magnetic resonance imaging were performed to assess LV function and MAD presence. Results MAD (+) MVP (n = 34), MAD (−) MVP (n = 69), and control (n = 40) groups were enrolled in the study. Among the MVP patients, 34 (33%) had MAD. T‐negativity in the inferior leads on electrocardiography was more frequent in the MAD (+) group than in the MAD (−) patients (4.3% vs. 20.6%, p = .014). Mitral regurgitation degree, Pickelhaube sign (17.6% vs. 1.4%, p = .005), and late gadolinium enhancement frequency (35.3% vs. 10.6%, p = .002) were significantly higher in MAD (+) patients. MAD (+) patients had significantly impaired global longitudinal strain (−23.1 ± 2.1 vs. −23.5 ± 2.3, p