Scientific Sessions 2025  /  Left and Right: Evolving Concepts in Mitral and Tricuspid Valve Pathology  /  Association of Race with Disease Expression and Clinical Outcomes among Patients with Mitral Valve Prolapse
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American Heart Association

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Final ID: MP2545

Association of Race with Disease Expression and Clinical Outcomes among Patients with Mitral Valve Prolapse

Abstract Body (Do not enter title and authors here): Background: We do not clearly understand racial differences in risk profile, cardiac echocardiographic metrics among mitral valve prolapse (MVP) patients neither are differences in long-term outcome well characterized.
Objective: To assess the association between race, echocardiographic parameters, and clinical outcomes among MVP patients.
Methods: Baseline demographics, self reported race, echocardiographic data, medication use, and cardiovascular and medical comorbidities were evaluated for white and black patients with echocardiographic evidence of MVP (n=7751) at a large multi-hospital academic health system between 2010-2024. Patients with mitral and aortic valve procedures, mitral or aortic stenosis, infiltrative cardiomyopathies, HCM, EF<35%, and cancer were excluded. Long term outcomes regarding all-cause mortality, cardiovascular (CV) hospitalization for heart failure (HF), atrial fibrillation (AF), stroke and ventricular tachycardia/fibrillation/sudden cardiac arrest (VT/VF/SCA) were evaluated along with cardiac interventions. Multivariable Cox proportional hazard modeling was performed to impact of race on mortality and CV hospitalization.
Results: Although black (n=438, 5.6%) patients with MVP were younger (57±2 vs. 62.4±2,P<0.001), they had more cardiovascular risk factors (diabetes (17% vs 7%, p<0.001), hypertension (53% vs 40%, p<0.001) chronic kidney disease (8% vs 3.4%, p<0.001)), higher comorbidity burden (Charlson Comorbidity Index 1.3±1.7 vs 0.73±1.1, p<0.001). Black patients had predominantly anterior MVP involvement (55% vs 29%) and less severe MR at presentation but had lower EF (10% with 35-50% EF) and increased pulmonary artery systolic pressures across age spectrum (Figure 1,2). Black patients experienced significantly increased comorbidity adjusted all-cause mortality (HR 1.2, CI 1-1.5, p=0.05) and CV hospitalizations (HR 1.36, CI1.1-1.6, p=0.003) particularly related to HF and VT/VF/SCA (Figure 2). However, black patients were less likely to undergo surgical mitral valve repair or ICD implantation (Figure 3).
Conclusion: Significant racial differences in disease expression, clinical outcomes and healthcare utilization exist between white and non-white mitral valve prolapse patients. Further research is needed to understand valvular phenotype and treatment gaps in MVP patients across racial and ethnic groups to improve outcomes.
  • Desai, Aishwary  ( University of Pittsburgh , Pittsburgh , Pennsylvania , United States )
  • Shalaby, Alaa  ( Univ of Pittsburgh School of Med , Pittsburgh , Pennsylvania , United States )
  • Estes, Nathan  ( UPMC , Pittsburgh , Pennsylvania , United States )
  • Saba, Samir  ( UPMC , Pittsburgh , Pennsylvania , United States )
  • Jain, Sandeep  ( UNIV PITTSBURGH , Wexford , Pennsylvania , United States )
  • Bhonsale, Aditya  ( University of Pittsburgh Med Cen , Pittsburgh , Pennsylvania , United States )
  • Thoma, Floyd  ( UPMC PRESBYTERIAN-SHADYSIDE , Pittsburgh , Pennsylvania , United States )
  • Naniwadekar, Aditi  ( University of Pittsburgh Med Cen , Pittsburgh , Pennsylvania , United States )
  • Singla, Virginia  ( University of Pittsburgh Med Cen , Pittsburgh , Pennsylvania , United States )
  • Wong, Timothy  ( UPMC HVI , Pittsburgh , Pennsylvania , United States )
  • Kancharla, Krishna  ( university of Pittsburgh , Pittsburgh , Pennsylvania , United States )
  • Mulukutla, Suresh  ( University of Pittsburgh Medical Center , Wexford , Pennsylvania , United States )
  • Katz, William  ( UPMC , Cheswick , Pennsylvania , United States )
  • Voigt, Andrew  ( University of Pittsburgh Med Cen , Pittsburgh , Pennsylvania , United States )
    • Author Disclosures:
    Aishwary Desai: DO NOT have relevant financial relationships | Alaa Shalaby: No Answer | Nathan Estes: DO NOT have relevant financial relationships | Samir Saba: DO have relevant financial relationships ; Researcher:Abbott:Active (exists now) ; Researcher:Boston Scientific:Active (exists now) ; Advisor:Medtronic:Active (exists now) ; Advisor:Boston Scientific:Active (exists now) | Sandeep Jain: DO NOT have relevant financial relationships | Aditya Bhonsale: DO NOT have relevant financial relationships | Floyd Thoma: DO NOT have relevant financial relationships | Aditi Naniwadekar: No Answer | Virginia Singla: No Answer | Timothy Wong: DO have relevant financial relationships ; Research Funding (PI or named investigator):Bristol Myers Squibb:Active (exists now) ; Research Funding (PI or named investigator):Tenaya Therapeutics:Past (completed) ; Research Funding (PI or named investigator):Cytokinetics:Active (exists now) | krishna kancharla: DO NOT have relevant financial relationships | Suresh Mulukutla: DO NOT have relevant financial relationships | William Katz: DO NOT have relevant financial relationships | Andrew Voigt: No Answer
Meeting Info:

Scientific Sessions 2025

2025

New Orleans, Louisiana

Session Info:

Left and Right: Evolving Concepts in Mitral and Tricuspid Valve Pathology

Monday, 11/10/2025 , 12:15PM - 12:55PM

Moderated Digital Poster Session

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