Abstract
The prevalence of mitral valve prolapse (MVP) among middle- and older-aged individuals is estimated to be 2–4% in Western countries. However, few studies have been conducted among Asian individuals and young adults. This study included a sample of 2442 consecutive military adults aged 18–39 years in Hualien, Taiwan. MVP was defined as displacement of the anterior or posterior leaflet of the mitral valve to the mid portion of the annular hinge point > 2 mm in the parasternal long-axis view of echocardiography. Cardiac chamber size and wall thickness were measured based on the latest criteria of the American Society of Echocardiography. The clinical features of participants with MVP and those without MVP were compared using a two-sample t test, and the cardiac structures were compared using analysis of covariance with adjustment for body surface area (BSA). Eighty-two participants were diagnosed with MVP, and the prevalence was 3.36% in the overall population. Compared with those without MVP, participants with MVP had a lower body mass index (kg/m2) (24.89 ± 3.70 vs. 23.91 ± 3.45, p = 0.02) and higher prevalence of somatic symptoms related to exercise (11.0% vs. 4.9%, p = 0.02) and systolic click in auscultation (18.3% vs. 0.6%, p < 0.01). In addition, participants with MVP had greater left ventricular mass (gm) and smaller right ventricular wall thickness (mm) and dimensions (mm) indexed by BSA than those without MVP (149.12 ± 35.76 vs. 155.38 ± 36.26; 4.66 ± 0.63 vs. 4.40 ± 0.68; 26.57 ± 3.99 vs. 25.41 ± 4.35, respectively, all p-values < 0.01). In conclusion, the prevalence and clinical features of MVP in military young adults in Taiwan were in line with those in Western countries. Whether the novel MVP phenotype found in this study has any pathological meaning needs further investigation.
Highlights
Mitral valve prolapse (MVP) is one of the most common valvular heart diseases, with a prevalence of 2.0–4.0% in the general p opulation[1,2,3,4,5,6]
Participants with MVP had lower levels of body mass index (23.78 kg/m2 vs. 24.65 kg/m2, P = 0.03) and fasting plasma glucose (90.3 mg/ dL vs. 93.63 mg/dL, P = 0.01), and had a higher prevalence of intolerable somatic symptoms including chest pain, dyspnea or easy palpitation during exercise (MVP syndrome, 9 of 82 [11.0%]) than those without MVP
The results showed that the participants with MVP had similar levels of LV mass, LV chamber size and anterior RV wall thickness indexed by body surface area (BSA) compared to those without MVP
Summary
Mitral valve prolapse (MVP) is one of the most common valvular heart diseases, with a prevalence of 2.0–4.0% in the general p opulation[1,2,3,4,5,6]. The Framingham Heart Study[1] has shown that MVP is regarded as a benign condition with a low incidence of complications in the general population, numerous studies have uncovered several adverse events, such as ischemic s troke[14], bacterial endocarditis[15,16], severe mitral r egurgitation[2,4,17], lethal a rrhythmia[18,19] and sudden cardiac d eath[20] related to MVP. In addition to the Framingham Heart Study that mainly Caucasian participants[21,22], the clinical characteristics of MVP were investigated in a cohort of American Indians in the Strong Heart Study[2], and in a small sample of Canadian adolescents of European, South Asian and Chinese descent in the Study of Health Assessment and Risk in Ethnic groups (SHARE)[5]. The purpose of this study was to determine the prevalence, clinical features and echocardiographic profiles of MVP in a large Asian military cohort in T aiwan[23,24]
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