Frequency Of Mitral Valve Prolapse Research Articles

Echocardiographic screening for mitral valve prolapse in Turkish school children

We determined the frequency of mitral valve prolapse (MVP) in healthy Turkish school children using the current echocardiographic diagnostic criteria. This epidemiological survey was performed on 2550 school children. All children were screened with echocardiography and the family of children with MVP were also screened. The prolapse of mitral leaflets into left atrium ≥ 2mm in parasternal long-axis view was used as diagnostic criteria. MVP was classified as classical or non-classical according to anterior mitral leaflet thickness. The thickness of anterior mitral leaflet, the extent of prolapse, and the presence of mitral regurgitation were evaluated. The children were also questioned about the associated symptoms. The prevalence of MVP was 1.25% in children with a mean age of 11.1 ± 2.9years. The prevalence was 0.9%, 1.2%, and 1.6% in 5-9years, 10-13years, and 14-18years of age, respectively. 43.7% of the cases were classical MVP. The frequency of auscultation findings was 34.3%. 11/34 children had mitral regurgitation. There was no statistically significant difference between classical MVP and non-classical MVP in terms of mitral regurgitation, physical examination findings, and symptoms. Anxiety (37.5%) was the most common symptom. The frequency of MVP in the first-degree relatives of children with MVP was 11/84 (13.1%). Most patients with MVP don't have auscultation findings and symptoms, therefore echocardiography is an important tool in the diagnosis of MVP. It is also reasonable to screen first degree relatives of MVP patients with echocardiography.

The mitral valve prolapse frequency in healthy females with generalized joint hypermobility: A case-control study.

Objectives The aim of this study was to investigate the frequency of mitral valve prolapse between healthy females with generalized joint hypermobility and healthy controls.Patients and methods This observational, cross-sectional, controlled study included female individuals with generalized joint hypermobility (n=39, mean age: 20.5±1.1 years; range, 19 to 23 years) and healthy controls (n=42, mean age: 20.6±1.2 years; range, 18 to 23 years) between July 2017 and November 2017. The generalized joint hypermobility consisted of women with a Beighton score of ≥4, while the control group consisted of women with a Beighton score of ≤3. Echocardiography was performed to all participants. Mitral valve prolapse was defined as having single or bileaflet prolapse of at least 2 mm beyond the long-axis annular plane with or without mitral leaflet thickening.Results No significant difference was found in the age, height, body weight, and body mass index between the groups (p>0.05). The median Beighton score was 5 in the generalized joint hypermobility group and 2 in the control group. No mitral valve prolapse was detected in those with generalized joint hypermobility, while non-classical mitral valve prolapse was observed in one participant in the control group, indicating no statistically significant difference between the two groups (p>0.05).Conclusion Our study results suggest that the frequency of mitral valve prolapse is comparable between the women with generalized joint hypermobility and healthy controls. Based on these results, routine assessment of mitral valve prolapse is not recommended in this population.

Mitral Valve Prolapse in Young and Middle-aged Patients with Hypertension

One of the risk factors that plays an important role in the pathogenesis but is insufficiently studied in the development and progression of hypertension (AH) is the presence of connective tissue dysplasia (СTD). CTD are genetically determined conditions characterized by defects in fibrous structures and the main substance of connective tissue (CT), which lead to disruption of the formation of organs and systems, have a progressive course and determine the features of the associated pathology.The objective: study of the frequency and severity of mitral valve prolapse in patients with hypertension.Materials and methods. We examined 153 patients with primary hypertension I–II stage 1 – 3 degrees (90 men and 63 women) aged 22 to 45 years.Results. Mitral valve prolapse (MVP) was detected in 32 % of patients with hypertension (grade 1 MVP – in 21 % of patients and grade 2 – in 11 %, respectively. The frequency of MVP in stage I hypertension was established than in stage II. MVP with mitral regurgitation of 1–2 degrees was higher in hypertension of stage II in comparison with AH of stage I. MVP of 1 degree was most often associated with increased variability of systolic blood pressure (SBP), and MVP of 2 degree – with increased SBP load and type of daily profile «non-dipper» BP was characterized by a higher incidence of left ventricular hypertrophy (LVH) and supraventricular arrhythmias than in patients without MVP, with an increase in the concentration of free oxyproline in the blood in patients with grade 1 hypertension and total oxyproline – in patients with hypertension with MVP 2 degree.Conclusions. It was found that 32 % of patients with hypertension of young and middle age have MVP 1–2 degrees. An increase in the frequency of MVP in general (1 and 2 degrees) in patients with stage I hypertension, compared with patients with stage II hypertension, as well as the frequency of stage 1 MVP in patients with stage I hypertension compared with patients with stage II hypertension. At the same time, the frequency of MVP 2 degree and MVP with MR 1–2 degree was higher in patients with stage II hypertension compared with stage I hypertension. Patients with hypertension with MVP were characterized by a higher frequency of LVH and the occurrence of supraventricular arrhythmias than for patients without MVP. There was a significant increase in blood levels of free oxyproline in the group of patients with hypertension with MVP 1 degree compared with patients with MVP 2 degree and a significant increase in blood levels of total oxyproline in patients with MVP 2 degree compared with patients with MVP 1 degree.

Frequency of Mitral Valve Prolapse in Apparently Healthy Children in Alexandria Governorate

Background: Mitral valve prolapse is common with a reported prevalence ranging from 2–3%, Mitral valve prolapse and its possible complications is not yet studied in Egyptian children. Aim of the work: To study the frequency of mitral valve, prolapse in apparently healthy children aging between 3 to 15 years old. Patients and Methods:A cross sectional study, the study sample contained 150 apparently healthy child selected by non-systemic random sample, 78 males (52.0%) and 72 females (48.0%), with age ranged from 3-15 years old, the mean age was 2.36 years, living at Alexandria governorate and fulfilling the inclusion criteria coming for outpatient office visits for well child care at sporting students’ hospital, Alexandria, through the period from March 2018 through April 2019. Results: The frequency of mitral valve prolapse in children in Alexandria governorate was found in 18 cases (12.0%), 17 cases of them (11.4%) had mitral regurge [MR]. MVP was more frequent among females (63.6%) than males (36.4%) but the difference did not reach statistically significant difference (p>0.05). echocardiographic examination reflects the mild nature of the disease. Conclusion: Mitral valve prolapse reported in 12% of apparently healthy children, which reflects the magnitude of the problem. Female children were more affected. This indicates the importance of screening healthy children to early diagnose the condition and permit early treatment.

Is there any link between joint hypermobility and mitral valve prolapse in patients with fibromyalgia syndrome?

The objective of the present study is to determine whether benign joint hypermobility syndrome (BJHS) modifies the risk of mitral valve prolapse (MVP) in patients with fibromyalgia (FM). Female patients fulfilling the 1990 American College of Rheumatology (ACR) diagnostic criteria for FM were included into the study. Joint hypermobility and BJHS were assessed using Beighton's scoring system and Brighton criteria, respectively. Echocardiograpic evaluation was performed in order to test the presence of MVP. Of the 75 female FM patients, 68.0% (n = 51) and 20.0% (n = 15) were diagnosed with BJHS and MVP, respectively. The frequencies of both MVP and BJHS seemed higher than the general population prevalence (p = 0.000 for both). The frequency of MVP was significantly higher in patients with BJHS than that in patients without BJHS (p = 0.028). In addition, BJHS was found to increase the risk of MVP approximately ninefold [odds ratio (OR) 8.7, 95% confidence interval (CI) 1.1-70.7]. As a result, BJHS and MVP are both common in female patients with FM. Moreover, among the female patients with FM, those with BJHS are about nine times more prone to MVP than those without BJHS. Cardiologic assessment might be added to the routine follow-up strategies in FM patients with BJHS in order to exclude the cardiac pathologies, especially MVP.

Increased frequency of mitral valve prolapse in patients with deviated nasal septum.

Any abnormality of collagen may affect the tissues with higher collagen content, e.g., joints, heart valves, and great arteries. Mitral valve prolapse (MVP) is a characteristic of generalized collagen abnormality. Nasal septum (NS) is constituted by osseous and cartilaginous septums that are highly rich in collagen. We evaluated the co-existence of deviation of NS (DNS) in patients with MVP. We retrospectively evaluated the recordings of echocardiographic and nasal examinations of subjects with MVP and DNS. We analyzed the features of MVP and anatomical classification of DNS among subjects. Totally, 74 patients with DNS and 38 subjects with normal nasal passage were enrolled to the study. Presence of MVP was significantly higher in patients with DNS compared to normal subjects (63 vs 26%, p < 0.001). Prolapse of anterior, posterior and both leaflets was higher in patients with DNS. Thickness of anterior mitral leaflet was significantly increased in patients with DNS (3.57 ± 0.68 vs 4.59 ± 1.1 mm, p < 0.001) compared to normal subjects. Type I, II, and III, IV DNS were higher in frequency in patients with MVP while type V and VI were higher in normal subjects. DNS is highly co-existent with MVP and increased thickness of mitral anterior leaflet. Generalized abnormality of collagen which is the main component of mitral valves and nasal septum may be accounted for co-existence of MVP and DNS. Also co-existence of them may exaggerate the symptoms of patients with MVP due to limited airflow through the nasal passage.

Increased Frequency of Mitral Valve Prolapse in Patients with Nasal Septum Deviation

PP-407 Mitral valve prolapse (MVP) is a valvular heart disease which is closely associated with generalized disorder or disarray of collagen. So it is frequently observed in patients with Marfan's syndrome, Ehler Danlos, or Benign Joint Hypermobile Syndrome. Nasal septum has two components; osseous

A relationship between mitral valve prolapse and subtypes of supraventricular tachycardia

The aim of this study was to investigate the frequency of mitral valve prolapse (MVP) in patients with supraventricular tachycardia (SVT) who were diagnosed by intracardiac electrophysiological study (EPS). The study was a retrospective cohort of 378 adult patients (128 males and 250 females, 17 to 63 years) admitted with EPS. We included 267 SVT patients (58.4 % (n = 156) atria-ventricular nodal reentrant tachycardia (AVNRT), 30 % (n = 80) atria-ventricular reentrant tachycardia (AVRT), 6.4 % (n = 17) atrial tachycardia (AT), and 5.2 % (n = 14) other). MVP prevalence was compared in individuals with SVT. MVP prevalence was found 27.7 % (n = 74) in patients with SVT. In subgroup analyses, there was a significant difference between AVRT and others about MVP prevalence (AVRT 52.7 % n = 39, AVNRT 33.8 % n = 25, AT 9.5 % n = 7, and others 4.1 % n = 3; p < 0.005). Also, there was a significant difference between females and males (75.7 % (n = 56); 24.3 % (n = 18); p < 0.05). There was a significant negative correlation between age and MVP just in female group (r = -0.116, p = 0.024). It was demonstrated in our study that AVRT and female sex may be related to MVP in SVT patients. It was dedicated from these results that the existence of arrhythmia should be focused on young female subjects with MVP more than the others.

Frequency and Age-Related Course of Mitral Valve Dysfunction in the Marfan Syndrome

Mitral valve (MV) prolapse (MVP) has a high prevalence of 2% to 3% in the general population and thus constitutes the most common cause of severe nonischemic MV regurgitation (MVR). MVP is also common in persons with the Marfan syndrome. However, to date, a large-scale population-based cohort study using modern echocardiographic techniques has not been performed, and the frequency of MVP and the relation of MV dysfunction and age have not been investigated. Therefore, we conducted a population-based cohort study of 204 patients (108 males and 96 females, aged 31.2 ± 16.4 years) with classic Marfan syndrome. We performed echocardiographic follow-up of 174 patients for a mean of 4.4 ± 4.3 years. On the initial or subsequent echocardiographic scan, MVP was present in 82 patients (40%), severe MVR in 25 (12%), and MV endocarditis in 5 patients (2.5%). At 30 years of age, the Weibull cumulative distribution was 42.6% (95% confidence interval [CI] 36% to 50%) for MVP, 56.5% (95% CI 49.3% to 64%) for MVR of any degree, 6.7% (95% CI 3.9% to 11.3%) for severe MVR, and 0.92% (95% CI 0.21% to 3.91%) for MV endocarditis. The cumulative hazard for severe MVR and MV endocarditis was estimated to increase with age. MVP was associated with dural ectasia (p = 0.01), ectopia lentis (p = 0.02), and skeletal involvement (p <0.001). Severe MVR was related to tricuspid valve prolapse (p = 0.002) and to the sporadic form of the Marfan syndrome (p = 0.006). In conclusion, MVP was comparatively frequent in patients with the Marfan syndrome and carries an increased risk of progression to severe MVR and endocarditis, especially in older adults.

An investigation into the frequency of mitral valve prolapse in von Willebrand disease.

The reported extremely high incidence of mitral valve prolapse in von Willebrand patients (60%) in combination with multiple signs of mesenchymal dysplasia points to a hitherto unknown pleiotropic effect of the von Willebrand gene and needs further confirmation. Therefore, we looked for the presence of mitral valve prolapse in 19 patients with classical von Willebrand disease. While 58% of these patients had one or more physical findings which could be interpreted as symptoms of mesenchymal dysplasia, we found only one patient with a mitral valve prolapse (5.3%), comparable to the 6% incidence in the normal population. Therefore, we must conclude that there is no association between mitral valve prolapse and von Willebrand disease.

Role of elastin polymorphisms in panic disorder.

Panic disorder (PD) is a complex neuropsychiatric disorder that has been associated with an increased frequency of mitral valve prolapse. Elastin is a prominent component of mitral valves and, in a genome screen of 23 pedigrees with PD, we found evidence of linkage to the region of chromosome 7 that contains the elastin gene (ELN). Therefore, we examined the minimal essential promoter and coding regions of ELN in 23 independent probands from the families in our linkage studies using single strand conformational polymorphism analysis. We found three polymorphisms including one that coded for a non-conservative amino acid change. However, none of these polymorphisms were associated with panic disorder in a case-control analysis or linked to it in multiplex pedigrees. In our pedigrees, exonic polymorphisms in ELN do not play a major role in the genetic vulnerability to PD.

Left Ventricular Shape Deformation and Mitral Valve Prolapse in Chronic Pulmonary Hypertension

Mitral valve prolapse (MVP) has been described in patients with right ventricular pressure or volume overload. The frequency of this phenomenon and its relationship to left ventricular shape and mitral valve annulus size, as well as its reversibility in chronic pulmonary hypertension, are poorly understood. We have observed an increased frequency of MVP in a patient population with chronic thromboembolic pulmonary hypertension that often resolves after thromboendarterectomy and reduction of pulmonary hypertension. To further evaluate the relationship between MVP and left ventricular shape in pulmonary hypertension, we studied 51 consecutive patients undergoing surgery for thromboembolic pulmonary hypertension. Echocardiographic features including interventricular septal position, as measured by an eccentricity index, left ventricular size, and several mitral valve annulus dimensions were evaluated prior to surgery and during the postoperative hospitalization period. The pulmonary artery systolic pressure was elevated for all patients prior to surgery, 87 ± 21 mmHg (mean ± SD). Twelve patients (23.5%) had MVP before surgery, which resolved in ten patients postoperatively. In addition, one patient whose pulmonary hypertension improved little, developed MVP postoperatively. Those patients with MVP had a greater pulmonary artery pressure preoperatively than those without MVP (102 ±19 vs 84 ±21 mmHg). The eccentricity index for those patients with MVP (1.68±0.2) was greater than for those with no MVP (1.53 ± 0.37). No significant differences were noted between groups with MVP and without MVP according to all mitral annulus dimensions or left ventricular chamber areas. Postoperatively, eccentricity index decreased significantly in both those with MVP and without MVP (1.29 ± 0.18 and 1.20 ± 0.15, respectively) as did pulmonary artery systolic pressure (67± 22 and 47 ± 13 mmHg, respectively). Mitral valve prolapse in chronic pulmonary hypertension occurs frequently and is noted particularly in those patients with the most severe pulmonary hypertension. It appears that deformation of the left ventricle is associated with echocardiographic MVP and that reduction of pulmonary hypertension reverses this deformation and allows for resolution of MVP.

Clinical and morphologic features of mitral valve prolapse in octogenarians

The frequency of mitral valve prolapse (MVP) in women decreases progressively from the third to the ninth decade of life; in men, in contrast, its frequency remains the same from the third to the ninth decade. 1 Of 264 patients with MVP detected by M-mode echocardiography and reported by Savage and associates, 1 only 4 (1.5%) were aged 80 years or over. A previous clinicopathologic study from this laboratory by Dollar and Roberts 2 included 56 patients aged 16 to 70 years. The present study examines clinical and morphologic findings in 12 octogenarians with MVP at necropsy. Although patients aged 80 to 89 years have been included in previous necropsy studies of MVP, 3,4 a study focusing exclusively on this age group has not been reported previously.

MITRAL VALVE PROLAPSE AS A RISK FACTOR FOR INFECTIVE ENDOCARDITIS

The frequency of mitral valve prolapse was assessed in 48 patients with mitral valve endocarditis and in 96 controls matched for age and sex, attending a routine family screening clinic or having surgery of the limbs. The frequency of mitral valve prolapse in cases with endocarditis (9 of 48 patients) was more than three times that in controls (6 of 96) (odds ratio 3·5; 95% confidence interval [CI] 1·1-10·5). When patients with rheumatic heart disease, an established risk factor for infective endocarditis, were excluded from the study group, patients were nearly six times more likely to have infective endocarditis than were controls (odds radio 5·7; 95% CI 1·8-18·4). However, a higher risk of infective endocarditis was seen only in the subjects with mitral valve prolapse and a previously known systolic murmur (odds ratio 14·5; 95% CI 1·7-125). The results indicate that mitral valve prolapse constitutes a true risk factor for infective endocarditis only when associated with the presence of a precordial systolic murmur.

Frequency of mitral valve prolapse in systemic lupus erythematosus, progressive systemic sclerosis and mixed connective tissue disease

Although various connective tissue diseases have been cited as secondary causes of mitral valve prolapse (MVP), conflicting information exists concerning the frequency of MVP in systemic lupus erythematosus (SLE), progressive systemic sclerosis and mixed connective tissue disease (MCTD). 1–6 This study determines whether MVP occurs with disproportionately high frequency in patients with these connective tissue diseases.

High frequency of mitral valve prolapse and aortic regurgitation among asymptomatic adults with Down's syndrome

Although cardiac anomalies are well documented among children with Down's syndrome, data on the cardiac status of adults with Down's syndrome are sparse. Therefore, we performed cardiac auscultation and Doppler echocardiographic examinations in 35 asymptomatic adults with Down's syndrome. There were 25 men and ten women; their mean age ( ± SD) was 26 ± 8 years. Only ten subjects (29%) had normal findings on examination. The most frequent abnormal findings were holosystolic mitral valve prolapse (MVP) in 20 subjects (57%) and mild aortic regurgitation in four subjects (11%). Of the 20 subjects with MVP, five had associated tricuspid valve prolapse, but none had notable mitral regurgitation. Thus, we found that the majority of asymptomatic adults with Down's syndrome had valvular heart abnormalities. The high frequency of MVP and aortic regurgitation suggests that these lesions may be specifically associated with Down's syndrome in adults. (<i>JAMA</i>1987;258:1793-1795)

High Frequency of Mitral Valve Prolapse and Aortic Regurgitation Among Asymptomatic Adults With Down's Syndrome

Although cardiac anomalies are well documented among children with Down's syndrome, data on the cardiac status of adults with Down's syndrome are sparse. Therefore, we performed cardiac auscultation and Doppler echocardiographic examinations in 35 asymptomatic adults with Down's syndrome. There were 25 men and ten women; their mean age (+/- SD) was 26 +/- 8 years. Only ten subjects (29%) had normal findings on examination. The most frequent abnormal findings were holosystolic mitral valve prolapse (MVP) in 20 subjects (57%) and mild aortic regurgitation in four subjects (11%). Of the 20 subjects with MVP, five had associated tricuspid valve prolapse, but none had notable mitral regurgitation. Thus, we found that the majority of asymptomatic adults with Down's syndrome had valvular heart abnormalities. The high frequency of MVP and aortic regurgitation suggests that these lesions may be specifically associated with Down's syndrome in adults.

Aortic root dilatation and mitral valve prolapse in the fragile X syndrome.

Forty patients with fragile X [fra(X)] or Martin-Bell syndrome, confirmed by chromosome analysis, underwent full cardiac evaluation including physical examination, chest film, electrocardiography (ECG), and M-mode and 2-dimensional echocardiography. Thirty-four males and six females were studied. Although all patients were asymptomatic, seven males were found to have mild aortic root dilatation. All seven also had evidence of mitral valve prolapse. Twenty-two (55%) of the study patients had mitral valve prolapse with either a click or murmur heard on physical examination and confirmation by M-mode echocardiography. The frequency of mitral valve prolapse was the same in males and females, but 80% of males older than 18 years had mitral valve prolapse. These findings support the hypothesis of a connective tissue dysplasia in the fra(X) syndrome.

Mild mitral regurgitation and the mitral prolapse fiasco

The diagnosis, prognosis, and management of severe mitral regurgitation is comparatively well understood, and its exact cause is usually clear. Not surprisingly, the diagnosis of slight mitral reflux, its cause, prognosis, and management creates more difficulty and confusion, though some of this appears to result from some ill-considered statements and conclusions among the vast recent literature on the subject. Indeed, physicians may be puzzled by reading of chest pain,. dangerous dysrhythmias, and sudden death as serious considerations in what otherwise appears to be a trivial lesion, and even more puzzled by learning of the, great frequency of mitral valve prolapse on the echocardiogram varying from 4 to 21% of the population.‘. * These views are not in accord with our experience and continuing interest in this problem which extends over more than 25 years since we wrote on the subject in 1953.” Indeed, we hold the opinion that isolated disease of the mitral valve causing mild or moderate reflux seldom causes symptoms other than those of iatrogenic anxiety, and that the prognosis for this lesion is good, excepting the small risk of infective endocarditis and the very small one of progressive regurgitation usually as a result of chordal rupture. These divergent opinions result in uncertainties about the problem which appear to have arisen because there has been an “explosion of information,“” brought about by advances in the tools of biological research, and presented

Mitral valve prolapse in coronary artery disease

Mitral valve motion, left ventricular segmental contraction and severity of arterial stenosis were analyzed in 92 patients with coronary artery disease and 28 patients with “atypical chest pain” and normal coronary arteriograms. Mitral valve motion was evaluated for the presence or absence of leaflet prolapse. Segmental contraction was evaluated by calculating the percent shortening of six chords of the left ventricle measured from right anterior oblique ventriculograms. The severity of disease in each coronary vessel (left anterior descending, left circumflex and right coronary) was graded on a scale of 1 (0 to 30 percent stenosis) to 5 (complete occlusion). Mitral valve prolapse was not suspected clinically but observed angiographically in 15 of 92 patients with coronary artery disease and in 5 of 28 patients with normal coronary arteriograms. In nine patients with coronary artery disease, the prolapse was restricted to the posterior leaflet, in five it was in both the anterior and the posterior leaflets and in one patient in the anterior leaflet only. Mitral regurgitation was noted in seven patients with coronary artery disease; it was mild in six and moderate in one. Among the patients with coronary artery disease, 12 of the 15 (80 percent) with mitral valve prolapse had left ventricular asynergy compared with 63 of the 77 (82 percent) without valve prolapse. The mean scores for severity of disease in the left anterior descending, circumflex and right coronary arteries were, respectively, 4.2, 2.5 and 3.2 in the patients with valve prolapse and 4.2, 2.2 and 3.5 in those without prolapse. In summary, there was no significant correlation between mitral valve prolapse and distribution of coronary arterial obstructions or abnormal patterns of left ventricular segmental contraction. There was a high frequency of mitral valve prolapse in patients with severe coronary artery disease and in those with normal coronary arteriograms and atypical chest pain.