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Objective— Arrhythmias have been reported to occur frequently in symptomatic patients with mitral valve prolapse (MVP). The mechanisms causing atrial arrhythmias in patients with MVP have not been fully investigated. The purpose of this study was to determine the clinical, echocardiographic and heart rate variability parameters, and plasma concentrations of electrolytes and inflammatory markers in predicting atrial arrhythmias in patients with MVP.Methods— A total of 58 consecutive patients with MVP were included in this study.We performed electrocardiography, echocardiography, Holter analysis, routine biochemical tests including plasma concentrations of electrolytes and inflammatory markers, and evaluated the clinical characteristics. Atrial arrhythmia was defined as occurrence of any of the following: atrial premature contractions, atrial couplets, supraventricular tachycardia, atrial flutter or fibrillation documented by Holter analysis, continuous monitoring or by electrocardiography.Results— Twenty-eight patients (48%) had atrial arrhythmias, and 30 (52%) patients had no atrial arrhythmias. Univariable predictors of atrial arrhythmias included isovolumetric relaxation time, lateral systolic (S’), lateral late diastolic (A’), septal A’ Doppler velocities, anterior mitral leaflet thickness, anterior mitral leaflet thickness of < 5 mm, posterior mitral leaflet thickness and the occurrence of moderate to severe mitral regurgitation. Multivariable logistic regression analysis showed that occurrence of moderate to severe mitral regurgitation was the only independent predictor of atrial arrhythmias (relative risk: 2.4, 95% confidence interval 1.32-4.86, P = 0.005).Conclusions— The present study showed that the only independent predictor of atrial arrhythmias in patients with MVP is the occurrence of moderate to severe mitral regurgitation.

Objective— Recent studies have suggested a cytokine-induced tissue inflammation in the pathogenesis of abdominal aortic aneurysms and it has been documented that circulating interleukin-6 (IL-6) levels in these patients are increased.The aim of this study was to investigate whether a similar association also exists for patients with coronary ectasia, which may also be regarded as an abnormal dilatation of the arterial system.Methods and results— The study group was composed of 43 patients with coronary ectasia and 48 patients with normal coronary arteries constituted the control group. Coronary diameters were measured by quantitative angiography. A coronary diameter index was defined for each segment as the coronary diameter divided by the body surface area (BSA). A coronary segment with a diameter index of more than 1.5 fold of the control group was defined as ectatic. Baseline characteristics of the two groups were similar. Serum IL-6 levels were significantly higher in patients with coronary ectasia (5.18 ± 2.04 pg/ml vs. 4.13 ± 0.5 pg/ml, p = 0.002). There was no significant correlation with the maximal diameter of the most dilated coronary segment and IL-6 levels in patients with coronary ectasia (r = 0.10, p = 0.50).Conclusions— Results of this study have demonstrated increased levels of circulating IL-6 in patients with coronary ectasia which might indicate a possible role of inflammatory processes. Absence of a significant correlation between the dimensions of the ectatic segments and IL-6 levels might be due to the narrower range of the diameters of the coronary arteries compared with the abdominal aorta.