Mitral Valve Prolapse: Relationship of Echocardiography Characteristics to Natural History

Abstract

heart catheterization showed mild-to-moderate coronary artery disease with LV ejection fraction of 50-55%. The LV end-diastolic pressure was 15 mmHg and mean wedge pressure was 17 mmHg. There was no pulmonary hypertension with mean PA pressure of 17 mmHg consistent with the 2D echo findings. Prominent V waves were detected on wedge pressure tracings. Left ventriculography showed severe mitral regurgitation. Because of his worsening dyspnea on exertion and atrial fibrillation associated with MVP complicated by severe MR with already decompensated LV systolic function, he was referred for MV surgery.

Classic Mitral Valve Prolapse Causes Enlargement in Left Ventricle Even in the Absence of Significant Mitral Regurgitation

“…4 This disparity leads to redundancy of the affected leaflets, as presented in our results. Geometrical relationship between the LV, mitral valve, and valvular annulus is also influenced in addition to the histopathological changes in the valvular tissue.…”

“…1,4,15,16 But these studies are community based and all MVP patients in the community were included in the studies without performing any classic/nonclassic differentiation. Moreover, the diastolic diameters of LV in about half of the MVP patients were measured above the normal limits.…”

“…There are some studies such as the Framingham study showing that there is an enlargement in the LV in patients with MVP. 1,4,15,16 But these studies are community based and all MVP patients in the community were included in the studies without performing any classic/nonclassic differentiation. Since patients with MVP having moderate and/or severe MR were also included in the previous studies, data cannot conclude that the enlargement of LV is independent from MR. Additionally, there was no age limit for the patients included in the previous studies.…”

“…3,4 MVP syndrome is a multifactorial valvular abnormality. 1,2 MVP is defined as single or bileaflet prolapse, with or without leaflet thickening.…”

“…MVP with thickening of the valve leaflets greater than 5 mm is termed classic MVP. 3,4 MVP syndrome is a multifactorial valvular abnormality. It may be caused by histological abnormalities of valves and geometric disparities between the left ventricle (LV) and valvular annulus.…”