Incidence Of Mitral Valve Prolapse Research Articles

Increased incidence of mitral valve prolapse in children with pectus chest wall deformity.

Pectus anomalies constitute 95% of chest anomalies. Pectus carinatum (PC) and excavatum (PE) are often asymptomatic in childhood. However, symptoms and signs such as chest pain, dyspnea, and mitral valve prolapse (MVP) can be seen in pectus anomalies. Demographic characteristics and accompanying cardiac signs in children with pectus deformity were investigated. In this study, the clinical findings for children with pectus deformity, and the incidence of MVP and other concomitant heart diseases detected in echocardiographic examinations were evaluated. Eighty-two children with PE, 27 with PC, and 107 healthy children were included in this study. In the echocardiographic examination of PE, PC patients, and healthy children, MVP was detected with frequencies of 25%, 33%, and 2% respectively. The study showed that pectus anomalies were associated with an increased incidenceof MVP. All patients with pectus deformity should therefore undergo a screening echocardiogram in adolescence to assess for the presence of MVP.

Should mitral valve prolapse be considered as one of the risk factors for open angle glaucoma? A preliminary observation.

To assess the incidence of mitral valve prolapse in patients with newly diagnosed primary open angle glaucoma. The study included 12 patients without any other comorbidities or taking any general or local medications. Each patient underwent a full ophthalmological examination with visual field assessment and optical computed tomography of the macula and optic nerve head. Carotid Doppler ultrasound was performed to exclude impaired blood flow in this region and transthoracic echocardiography with assessment of the function and morphology of the heart valves. In the study group, mitral valve prolapse was found in seven patients (58.3%), while mitral valve regurgitation in 11 patients (91.7%). One case of normal pressure glaucoma and four cases of juvenile glaucoma were diagnosed. There were also other risk factors for glaucoma: myopia (58.3%), migraine headaches (41.7%), a positive family history of glaucoma (16.7%). Mitral valve prolapse could be indicated as a new risk factor for glaucoma. It seems reasonable to conduct screening tests for glaucoma in patients with mitral valve prolapse in the course of echocardiography.

PECTUS EXCAVATUM PATIENTS HAVE ABNORMAL MITRAL VALVE LEAFLET LENGTHS AND COAPTATION POINT WITHOUT SIGNIFICANT MR

Pectus excavatum (PE) patients have been reported to have a high incidence of mitral valve prolapse (MVP) and regurgitation (MR). We reviewed our transesophageal echocardiographic (TEE) experience with PE and observations that the mitral valve (MV) leaflets have an unusually lateral coaptation point

Myocardial remodeling and syndrome of minor cardiac abnormalities in athletes

During the recent decades, the syndrome of minor cardiac abnormalities becomes of high interest in terms of health maintenance and risk of cardiovascular diseases in different categories of healthy and presumably healthy persons, e. g. in athletes. In this article we present the results of a population-wide study of the prevalence of minor cardiac abnormalities e. g. mitral valve prolapse (MVP) in athletes. The correlates of cardiac abnormalities were analyzed in a group of high-dynamic sports. An incidence of MVP among professional high-qualification athletes was 3.3 %. Athletes with MVP were younger, and their training experience was lower. Our data contribute to the concept that MVP is associated with neither risk nor benefit to reach the excellence in sports. At the same time, in athletes with minor cardiac abnormalities the signs of cardiac overload were more prevalent compared to people with none.

Evaluation of Autoimmune Thyroid Disease in Patients with Mitral Valve Prolapse

Objective: The high incidence of non-organ specific autoantibodies in patients with mitral valve prolapse (MVP) may suggest an association between MVP and autoimmune diseases. A higher incidence of MVP in patients with chronic lymphocytic thyroiditis and Graves' disease has been demonstrated in various studies. In particular, an increased incidence of MVP in patients with auto- immune thyroid disease characterized with hyperthyroidism may suggest an association between MVP and thyroid functions. To the best of our knowledge, there is a lack of literature regarding the evaluation of autoimmune thyroid diseases in patients with MVP. This study primarily aimed to evaluate the autoimmune thyroid disease using thyroid ultrasonography and autoimmune thyroid antibodies in patients with MVP. Materials and Methods: Thyroid function tests, thyroid autoimmune antibodies, and thyroid ultrasonographic examination were evaluated in 30 patients with MVP (19 females and 11 males; mean age: 29.6±9.3 years) and 30 healthy volunteers (19 females and 11 males; mean age: 27.6±7.5 years). Results: Two groups were similar in terms of demographical and clinical characteristics. Evaluation of the thyroid functions, auto- immune thyroid antibodies, and thyroid ultrasonography revealed no statistically significant difference between the study groups. Conclusion: The results of the study suggest no association between MVP and autoimmune thyroid diseases. This requires further clarification with large-scaled studies.

Changing Epidemiology of Native Valve Infective Endocarditis

Introduction and objectives The aim of our study is to assess changes in the epidemiologic features of patients with native valve infective endocarditis. Methods We analyzed a prospective series of 228 cases of native valve infective endocarditis in non-intravenous drug users attending our center between 1987 and 2009. We compared three subperiods: 1987-1994 (67 cases), 1995-2002 (74 cases) and 2003-2009 (87 cases). Results The mean age of patients has progressively increased (38 ± 22 years in the first subperiod vs 60 ± 16 years in the third; P < .001), as has the proportion of cases without predisposing heart disease (25%, 46% and 67%; P < .001). Incidence of mitral valve prolapse remained stable (12%, 18% and 11%). Percentages of patients with predisposing heart disease and who were aware of their condition have fallen in recent years (45%, 27% and 21%; P < .001). A portal of entry for the infection could not be identified in 64%. Overall, Staphylococcus aureus is the most frequent causative organism (26%) whereas the percentage of cases caused by Streptococcus viridans remains unaltered (22%, 20% and 24%). Conclusions We found significant changes in the epidemiology of native valve infective endocarditis. The incidence of patients without predisposing heart disease has increased significantly and staphylococci are the most frequent causative organisms.

Cambios epidemiológicos de la endocarditis infecciosa sobre válvula nativa

Introduction and objectives The aim of our study is to assess changes in the epidemiologic features of patients with native valve infective endocarditis. Methods We analyzed a prospective series of 228 cases of native valve infective endocarditis in non-intravenous drug users attending our center between 1987 and 2009. We compared three subperiods: 1987-1994 (67 cases), 1995-2002 (74 cases) and 2003-2009 (87 cases). Results The mean age of patients has progressively increased (38±22 years in the first subperiod vs 60±16 years in the third; P<.001), as has the proportion of cases without predisposing heart disease (25%, 46% and 67%; P<.001). Incidence of mitral valve prolapse remained stable (12%, 18% and 11%). Percentages of patients with predisposing heart disease and who were aware of their condition have fallen in recent years (45%, 27% and 21%; P<.001). A portal of entry for the infection could not be identified in 64%. Overall, Staphylococcus aureus is the most frequent causative organism (26%) whereas the percentage of cases caused by Streptococcus viridans remains unaltered (22%, 20% and 24%). Conclusions We found significant changes in the epidemiology of native valve infective endocarditis. The incidence of patients without predisposing heart disease has increased significantly and staphylococci are the most frequent causative organisms. Full English text available from: www.revespcardiol.org

228 Echocardiographic Examination of the Incidence of Mitral Valve Prolapse and Interatrial Communication

Introduction: Mitral valve prolapse (MVP) is the most common anomaly of mitral valve with different incidence (using modern criteria) and different level of pathoanatomical abnormality. In most of the cases MVP is an isolated anomaly, but can be associated with other heart anomalies, most frequently with interatrial communication. Using the echocardiography several sequelae and complications of MVP can be identified, including mitral regurgitation, ruptured chordae, endocarditis or associations anomalies.Aim of presentation: Using the echocardiography examination to present mitral valve prolapse associated with different forms of interatrial communication.Methodology: Cross-sectional, Doppler and color-Doppler echocardiography examination.Results: During the period 2004 - 2009. in Echo-labor of Pediatrics Clinic in Prishtina were registered 214 children with MVP. 36 of them had one type of interatrial communications. Most often was persistent foramen ovale (22 children), hemodinamicly irrelevant. In 9 of them was registered restrictive ASD secundum type. 5 children had nonrestrictive ASD, one of them type VCS. In all children with nonrestrictive ASD closure was preformed, while in 2 of them open heart surgery was done.

Mitral Valve Prolapse in Marfan Syndrome: An Old Topic Revisited

The echocardiographic features of mitral valve prolapse (MVP) in Marfan syndrome have been well described, and the incidence of MVP in Marfan syndrome is reported to be 40-80%. However, most of the original research was performed in the late 1980s and early 1990s, when the diagnostic criteria for MVP were less specific. Our goal was to investigate the characteristics of MVP associated with Marfan syndrome using currently accepted diagnostic criteria for MVP. Between January 1990 and March 2004, 90 patients with definitive diagnosis of Marfan syndrome (based on standardized criteria with or without genetic testing) were referred to Massachusetts General Hospital for transthoracic echocardiography. Patients' gender, age, weight, height, and body surface area at initial examination were recorded. Mitral valve thickness and motion, the degree of mitral regurgitation and aortic regurgitation, and aortic dimensions were quantified blinded to patients' clinical information. There were 25 patients (28%) with MVP, among whom 80% had symmetrical bileaflet MVP. Patients with MVP had thicker mitral leaflets (5.0 +/- 1.0 mm vs. 1.8 +/- 0.5 mm, P < 0.001), more mitral regurgitation (using a scale of 1-4, 2.2 +/- 1.0 vs. 0.90 +/- 0.60, P < 0.0001), larger LVEDD, and larger dimensions of sinus of Valsalva, sinotubular junction, aortic arch, and descending aorta indexed to square root body surface area, when compared with those without MVP. When echocardiographic features of patients younger than 18 years of age and those of patients older than 18 were compared, adult Marfan patients had larger LA dimension (indexed to square root body surface area), larger sinotubular junction (indexed to square root body surface area), and more mitral regurgitation and aortic regurgitation. The prevalence of MVP in Marfan syndrome is lower than previously reported. The large majority of patients with MVP have bileaflet involvement, and those with MVP have significantly larger aortic root diameters, suggesting a diffuse disease process.

Mitral valve prolapse and cerebrovascular accidents in the young.

The incidence of stroke in the young is reported to be high in India. The role of the mitral valve prolapse (MVP) syndrome in these patients is not clear. A prospective study over a period of 1 year was carried out in order to evaluate the role of MVP in cases of stroke occurring in patients below the age of 40 years. Of the 38 cases of stroke in the young seen during this period, well-recognised risk factors of stroke could be detected in 17. MVP confirmed by M-mode echocardiography was seen in 13% of all stroke patients and in 23.8% of those in which there were no other risk factors. The incidence of MVP was much higher if only the clinical criteria for diagnosis were used. We believe that MVP is a significant risk factor in younger stroke patients, and, in such cases, merits investigation. The probable pathogenic mechanisms and therapeutic implications are discussed.

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.

The prospective follow-up of the natural course of interatrial communications diagnosed in 847 newborns

The aim of this study was to evaluate the prevalance of interatrial communications (IACs) and IAC types in a large series of newborns, to establish the incidence of spontaneous closure of IACs, to determine the relationship between spontaneous closure and the size and type of IACs, and to investigate the incidence of mitral valve prolapse (MVP) and atrial arrhythmia in newborn infants with atrial septal aneurysm (ASA). Between 2000 and 2001, a total of 1100 asymptomatic and term newborns were evaluated. Those who had congenital heart diseases and failed to attend the follow-up visits were excluded from the study. The remaining 847 newborns were followed until the closure time or in those where closure did not occur, for a maximum time of 45 months (mean 25 +/- 3 months, range 1-45 months). The mean age at diagnosis was 1.7 +/- 1.4 days (range 1-7 days). According to echocardiographic evaluation, cases were classified into four groups based on the initial size of IAC and into three groups based on the type of IAC. At the end of the 45th month IACs were closed spontaneously in 98.6% of the cases. There was significant relationship between the diameter of IAC and the timing of the closure (P < 0.01). The closure time in the cases with ASA was significantly longer than the cases with valve-like opening and multiple fenestration (P < 0.01). In female newborns, the defects remained open for a significantly longer period than male newborns (P = 0.0397). There was no significant relationship between ASA and atrial arrhythmias (P = 0.294). None of the newborns had MVP. The cases with IACs < 3 mm do not need follow-up. However, the cases with IACs > 3 mm do need to be followed until the defect closes completely. Those with ASA should be followed-up regularly, because these defects can remain open. Spontaneous closure occurs significantly earlier in cases with valve-like opening and multiple fenestration.

Prevalence of mitral valve prolapse in Stickler syndrome.

The prevalence of mitral valve prolapse in Stickler syndrome has been reported to be much higher than in the general population. As a result, it has been recommended that all patients with Stickler syndrome undergo routine echocardiography and have antibiotic prophylaxis prior to surgery. The purpose of this study was to evaluate the prevalence of mitral valve prolapse in a large cohort of UK patients with Stickler syndrome in whom the clinical diagnosis has been confirmed by molecular genetic analysis. Probands and pedigrees were identified from the Vitreoretinal Service database according to previously published criteria. Ophthalmic, skeletal, audiometric, and orofacial features were assessed. Affected individuals underwent a full cardiological examination including auscultation and two-dimensional echocardiography. Mutation analysis of the COL2A1 and COL11A1 genes was carried out. Seventy-eight patients from 25 pedigrees were studied. Mutation analysis confirmed the clinical diagnosis in every pedigree. No patient was found to have clinical evidence of cardiovascular disease and no patient had significant mitral or other valvular prolapse on echocardiography. These data from a large cohort of UK patients with proven Stickler syndrome do not suggest an increased incidence of mitral valve prolapse over and above that found in the general population. Routine echocardiography screening and use of preoperative antibiotics are unnecessary and should be reserved for those individual cases where there is clear clinical indication.

Hypermobility Syndrome

Hypermobility Syndrome

Hypomagnesemia and mitral valve prolapse in Cavalier King Charles spaniels.

There is a high incidence of mitral valve prolapse (MVP), an abnormal displacement of one or both mitral valve leaflets during systole, in Cavalier King Charles Spaniels (CKCS). In humans, MVP is known to be associated with a low magnesium status. In this study, the plasma magnesium concentration was measured in 30 CKCS without heart failure. It was also investigated whether MVP-severity and degree of regurgitation correlated with plasma magnesium and a number of parameters of the renin-angiotensin system, and whether 4 weeks magnesium supplementation affected plasma magnesium or the high renin/low aldosterone profile associated with MVP. A high prevalence of hypomagnesemia was observed: plasma concentrations < 0.70 mmol/l were found in 15 dogs (50%) before and in 12 dogs (40%) after 4 weeks magnesium supplementation. The mean plasma level was 0.69 +/- 0.07 mmol/l before and 0.71 +/- 0.07 mmol/l after magnesium (P = 0.22). Plasma magnesium concentrations did not correlate with MVP-severity and degree of regurgitation. Plasma aldosterone levels correlated negatively with MVP-severity and positively with the degree of regurgitation, and serum angiotensin-converting enzyme activities correlated negatively with the degree of regurgitation. Magnesium supplementation had no effects on renin and aldosterone nor on the ratio between the two. In conclusion, many CKCS without heart failure have hypomagnesemia whether they are fed supplementary magnesium or not--a finding which may be associated with the high prevalence of MVP in this breed. Further studies, however, are needed to clarify the role of a low magnesium status in canine MVP.

Mitral valve prolapse and autonomic function in panic disorder.

We investigated the significance of mitral valve prolapse (MVP) and autonomic function in 121 patients diagnosed with panic disorder (PD). The incidence of MVP was higher in these patients (32.2%) than in the healthy controls (16.7%), but the difference was not significant. In the group with PD accompanied by depression, the MVP rate was 58.1%, significantly higher than the value of 25.7% observed in the PD patients without depression. The severity of MVP was mild; nearly all of the cases were silent, without cardiac murmur, and there was no problem with the left ventricular function. The coefficient of variation for R-R intervals on electrocardiograms (CV R-R) was smaller in patients with PD than in healthy controls. The CV R-R of PD patients was significantly lower in the group with MVP than in the group without MVP, suggesting a strong association with the parasympathetic nervous system. Since the CV R-R tended to decrease in the presence of depression, involvement of the parasympathetic nervous system was inferred.

Ventricular Fibrillation During Anesthetic Induction in a Child With Undiagnosed Mitral Valve Prolapse

Ventricular Fibrillation During Anesthetic Induction in a Child With Undiagnosed Mitral Valve Prolapse

Cardiovascular abnormalities in children with autosomal dominant polycystic kidney disease.

It is known that adults with autosomal dominant polycystic kidney disease (ADPKD) have an increased incidence of cardiovascular abnormalities, including mitral valve prolapse. The cardiac manifestations of ADPKD in the pediatric population have not been well established. To determine the cardiac manifestations of children with ADPKD, echocardiography was performed in 154 children of 66 families in which one parent has ADPKD. Eighty-six affected children and 68 unaffected children were evaluated in a prospective, single-blinded manner by echocardiography. Affected children were defined as those with any cysts on a concurrent renal ultrasound or those predicted to be gene carriers by gene linkage analysis. A 12% incidence of mitral valve prolapse was found in the affected children compared with only 3% of the unaffected children (P < 0.05). ADPKD children, but not their unaffected siblings, demonstrate a significant correlation between left ventricular mass index and systolic blood pressure. Moreover, hypertensive ADPKD children have significantly larger left ventricular mass index than do normotensive ADPKD children. A 3.5% incidence of congenital heart disease was found in the affected group, whereas 2.9% of the unaffected children had congenital heart disease. It was concluded that systemic manifestations of ADPKD, particularly cardiovascular abnormalities, are present even in childhood and these warrant the clinician's attention.

Juvenile autoimmune thyroiditis and mitral valve prolapse.

An increased incidence of mitral valve prolapse (MVP) has been reported in adult patients with autoimmune thyroid disease. The aim of this study was to assess the incidence of MVP in children and adolescents with juvenile autoimmune thyroiditis (JAT). Cardiac echo studies using M-mode, 2D, and Doppler examinations were performed on 23 patients (21 females, 2 males). The patients were studied at a median age of 12 years (range 5-20 years). Only one patient was found to have evidence suggestive of MVP, an incidence (4.3%) similar to that seen in the normal pediatric population. We, therefore, conclude that the incidence of MVP in children and adolescence with JAT is not increased.

Mitral Valve Prolapse in Childhood: The Incidence and Clinical Presentations in Different Age Groups

To elucidate the incidence and natural history of mitral valve prolapse (MVP) during childhood, we investigated a total of 4,238 children (aged from 1 day to 15 years) classified by age into 4 groups: Group 1:1 to 28-day-old full-term normal newborns (n = 108), Group 2: 6 to 18-month-old infants (n = 391), Group 3: 6 to 7-year-old children (n = 2,801), and Group 4: 12 to 15-year-old children (n = 938). The incidence of MVP was determined by videorecorded two-dimensional echocardiography in a double-blind method twice-over. There were 109 cases diagnosed as having MVP. The incidence rates of MVP were as follows: Group 1: 0%, Group 2: 0.25%, Group 3: 2.1% and Group 4: 5.1%. Arrhythmias were detected in 49% (27/55) by Holter ECG, and by exercise stress test in 4.7% (2/43). Eighty-three (77%) of 108 cases in Groups 3 and 4, excluding the 1 case in Group 2, showed no symptoms. Ventricular premature contraction (VPC) was the most common arrhythmia, and was benign in all cases. A mid-systolic click (MSC), late systolic murmur (LSM), MSC + LSM, and a pansystolic murmur were detected in 23.1%, 3.7%, 4.6% and 5.6%, respectively. Symptoms caused by MVP increased and appeared more apparently with age. Further prospective long-term follow-up studies to adulthood are necessary.