Sensitivity and specificity of two-dimensional echocardiographic signs of mitral valve prolapse

Alpert, Martin A.; Carney, Robert J.; Flaker, Greg C.; Sanfelippo, John F.; Webel, Richard; Kelly, Diana L.

doi:10.1016/s0002-9149(84)80210-6

Cited by 45 publications

(10 citation statements)

References 16 publications

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“…The diagnostic criteria recently proposed by Warth et al 7 were used; viz., superior motion of one or both mitral leaflets above the plane of the mitral annulus in the parasternal long axis view or superior systolic motion of the posterior mitral leaflet in any view. It is recognized that these criteria are more stringent than those previously reported by Alpert et al 10 2. M-mode studies.…”

Section: Methodsmentioning

confidence: 80%

Prevalence of Mitral Valve Prolapse in Presumably Healthy Young Saudi Men

et al. 1988

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Echocardiographic and clinical data of 118 presumably healthy young Saudi medical students were analyzed to determine the prevalence of mitral valve prolapse (MVP). Eight subjects satisfied the predefined criteria for echocardiographic diagnosis of MVP, giving a prevalence rate of 7.4%. Three of these patients were symptomatic with dyspnea, chest pains, or palpitations. However, a similar occurrence of symptoms was noted in the MVPnegative group. Three of the eight patients had auscultatory evidence of MVP. The prevalence rate for MVP in Saudi Arabia is comparable to that reported from other countries. 2 prevalence of MVP has been noted to be 1.4%. Multiple studies have noted the prevalence of MVP in healthy young women to vary from 6% to 21%.3,4 Sparbaro et al, 5 in their study of prevalence of MVP in healthy young men, report it to be 4%. The condition has been described in both sexes and at all ages, including newborn babies 6 and normal children. 7There seems to be no established racial predilection. A recent report documents a 2.5% prevalence of MVP in previously healthy Korean immigrants. 8 A prevalence figure of 8% and 7%, respectively, has been reported for healthy women and men from Sweden. 9The objective of this study was to assess the prevalence of MVP among Saudi Arab males. Subjects and MethodsOne hundred eighteen presumably healthy, male Saudi medical students were the subjects of this study. The nature and purpose of the study were explained. Individuals with previously known cardiac conditions (other than MVP) were excluded. Each participant completed a medical questionnaire which defined his symptomatic status pertaining to dyspnea, fatigability, chest pain, palpitation, dizzy spells, or syncope. A full clinical and cardiovascular examination was performed independently by at least two investigators. Thoracic cage abnormalities such as pectus excavatum, scoliosis, and straight back syndrome were specially sought.

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Section: Methodsmentioning

confidence: 80%

Prevalence of Mitral Valve Prolapse in Presumably Healthy Young Saudi Men

et al. 1988

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“…However, the sensitivity of the method depends very much on the use of different examination planes and selected combinations of echocard iographic signs. 17 From the point of view of pathology, the primary problem is the infiltration by a myxomatous material that varies greatly according to the extent of valve involvement. 1819 Postmortem studies in young patients with myxomatous valve involvement described endocardial friction lesions and platelet-fibrin deposits between the posterior mitral leaflet and the left atrial wall.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal two-dimensional echocardiography in young patients with cerebral ischemic events.

Zenker

Erbel

Mohr-Kahaly

et al. 1988

Stroke

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Using transesophageal echocardiography, cardiac structures can be imaged with high resolution. The aim of our study was to evaluate whether transesophageal echocardiography is superior in detecting mitral valve prolapse and other cardiac abnormalities compared with transthoracic echocardiography in an age-matched control group and in young patients with cerebral ischemic events (patient group). Forty patients with cerebral ischemic events (mean age 35.2 years) and 29 controls (mean age 30.4 years) were examined using both methods. Transthoracic and transesophageal echocardiography showed a significantly higher incidence of mitral valve prolapse in the patient group compared with the control group (p<0.001). By means of transesophageal echocardiography, it was possible to measure highly significant bulging in both the anterior and the posterior mitral leaflet in the patient group compared with the control group (p<0.001), and the thickness of the mitral leaflets was significantly higher in the patient group. In 9 of 20 (45%) patients with normal transthoracic echocardiograms, transesophageal echocardiography showed pathologic findings. We found transesophageal echocardiography to be a sensitive method for detecting mitral valve prolapse as well as valve changes and other cardiac abnormalities not detectable by conventional echocardiography. Our study underlines the role of mitral valve prolapse in young stroke patients as a relevant risk factor and emphasizes the importance of changed mitral valve morphology. {Stroke 1988;19:345-348)A series of studies has demonstrated an association of mitral valve prolapse (MVP) with cerebral ischemic events in younger patients.1 " 4 In 1980, Barnett and coworkers, by means of M-mode echocardiography, pointed out that the incidence of MVP in stroke patients <45 years of age was significantly higher (40%) than in age-matched controls.5 An increasing number of reports indicate that it is necessary to differentiate between "normal" MVP and a pathologic form with valve thickening and a high degree of myxomatous tissue change. 67 Some clinical retrospective studies address the possibility that the extent of valve involvement may influence the risk of embolic stroke. 8 -9 Transesophageal echocardiography (TEE) is a recently developed imaging technique with a very high degree of reliability and excellent resolution of the cardiac structures, especially the mitral valve.10 Until now, it has not been used for the cardiologic examination of younger patients with cerebral ischemic events.Our investigation examined whether TEE can provide additional diagnostic information in comparison with conventional transthoracic echocardiography ( r i b ) in patients with cerebral ischemic events and in Received March 14, 1987; accepted November 25, 1987. age-matched controls. In addition, we were also interested in analyzing the incidence of MVP by TEE, in quantifying the bulging of the mitral leaflets over the valve plane in normal and changed valves, and in performing measurements related to va...

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“…Mitral valve prolapse was diagnosed according to the criteria suggested by Alpert et al 8 and Popp et al, 9 with arching or systolic billowing of one or both mitral leaflets posteriorly and superiorly into the left atrium after crossing the plane of the mitral annulus, and doming of the anterior mitral leaflet characterized by a helmetshaped deformity during diastole. Recently, Levine stated that technological progress advances our understanding and ability, especially if two-dimensional images could be combined to display three-dimensional relationships, which allow quantitative description of the mitral valve leaflets' position relative to the annulus.…”

Section: Methodsmentioning

confidence: 99%

Clinical Spectrum of Skeletal Abnormalties and Mitral Valve Prolapse and Their Clinical Implications

Nouh¹,

Al-Nozha²,

Arafa³

et al. 1996

Ann Saudi Med

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Fifty-six patients were diagnosed to have mitral valve prolapse (MVP) syndrome by auscultatory criteria, confirmed by cross-sectional echocardiography. Complete physical examination and x-ray of the bony thorax revealed bony deformities which were subdivided into four main groups according to the predominant deformity. Shallow chest with pectus excavatum, straight back, kyphoscoliosis and elliptical chest in marfanoid patients were reported in the cases studied. It is concluded that musculoskeletal abnormalities have to be considered as nonauscultatory features of MVP. Therefore, any patient with musculoskeletal deformity has to be screened for MVP by cross-sectional echocardiography to prevent life-threatening complications.

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Sensitivity and specificity of two-dimensional echocardiographic signs of mitral valve prolapse

Cited by 45 publications

References 16 publications

Prevalence of Mitral Valve Prolapse in Presumably Healthy Young Saudi Men

Prevalence of Mitral Valve Prolapse in Presumably Healthy Young Saudi Men

Transesophageal two-dimensional echocardiography in young patients with cerebral ischemic events.

Clinical Spectrum of Skeletal Abnormalties and Mitral Valve Prolapse and Their Clinical Implications

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