Clinical and echocardiographic features of isolated severe pure mitral regurgitation

Abstract

Summary:Recent studies have shown that rheumatic heart disease is no longer the main cause of isolated severe pure mitral regurgitation. In this study, we evaluated various clinical and echocardiographic features found in the syndrome of mitral regurgitation. Our data is consistent with recent reports that mitral valve prolapse and coronary artery disease are now the predominant causes of mitral regurgitation and that rheumatic heart disease is a much less common etiology. In addition, our data suggest that clinical evaluation alone is usually very accurate in identifying the correct etiology. Various clinical and echocardiographic features found in the subsets of acute and chronic mitral regurgitation are described. Specifically, patients with acute mitral regurgitation were more likely to have echocardiographic evidence of segmental left ventricular dysfunction and flail mitral valve leaflet. In chronic mitral regurgitation, atrial fibrillation and left atrial dilatation were more commonly present. Echocardiography was found to be more useful in the detection of the

High Occurrence of Mitral Valve Prolapse in Cardiac Catheterization Patients with Pure Isolated Mitral Regurgitation

“…Even so, patients with rheumatic MR were still a relatively large group. Two other studies (11, 12) found rheumatic MR in 13% and 19% of their patients respectively, whereas in more recent studies (6, 7) and in the present one, the proportion of rheumatic MR has declined to 3 4 % . MVP (2-4), we found that 71% of our patients with MVP and significant MR were men.…”

“…To further select those with pure isolated MR the following definitions were used in accordance with other studies (6,7): Pure M R signifies the absence of coexistent mitral stenosis, verified by a mean diastolic pressure gradient across the mitral valve of <2 mmHg and no end-diastolic gradient. Isolated M R signifies absence of associated aortic valve dysfunction, where lack of stenosis is verified by a systolic Abbreviations: MR = mitral regurgitation, MVP = mitral valve prolapse, LV = left ventricle, RVD = rheumatic valve disease.…”