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Mitral Valve Prolapse (mitral + valve_prolapse)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Cardiovascular Disease	61%
Pediatrics	9%

Selected Abstracts

Mitral Valve Prolapse in Marfan Syndrome: An Old Topic Revisited

ECHOCARDIOGRAPHY, Issue 4 2009
Cynthia C. Taub M.D.
Background: 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. Methods: 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. Results: 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. Conclusions: 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. [source]

Mitral Valve Prolapse: Relationship of Echocardiography Characteristics to Natural History

ECHOCARDIOGRAPHY, Issue 5 2006
Bassam K. Mechleb M.D.
First page of article [source]

Anterior Mitral Valve Length is Associated with Ventricular Tachycardia in Patients with Classical Mitral Valve Prolapse

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2010
MURAT AKCAY M.D.
Background: The aim of this study was to investigate the electrocardiographic and echocardiographic predictors of ventricular tachycardia (VT) in patients with classical mitral valve prolapse (MVP). Methods: Thirty patients (nine men and 21 women; mean age, 41.5 ± 15 years) in sinus rhythm with mitral valve prolapse who had VT in 24-hour Holter analysis and 30 patients with MVP without VT (eight men and 22 women; mean age, 43 ± 16 years) were included in this study. Transthoracic echocardiography, QT analyses from 12-lead electrocardiography, and 24-hour Holter electrocardiogram recordings were performed. Results: Mitral posterior leaflet thickness (0.48 ± 0.03 cm vs 0.43 ± 0,08 cm, P = 0.025), mitral anterior leaflet length (3.2 ± 0.24 cm vs 2.9 ± 0.36, P < 0.001), mitral posterior leaflet length (2.2 ± 0.3 cm vs 1.9 ± 0.35 cm, P = 0.01), left atrium anteroposterior diameter (4.2 ± 0.8 cm vs 3.5 ± 0.5 cm, P = 0.001), and mitral annulus circumference (15.7 ± 1.3 cm vs 14.6 ± 1.6 cm, P = 0.004) were increased significantly in MVP cases with VT. No significant difference was found between the cases with and without VT in terms of frequency- and time-domain analysis. QT dispersion (72 ± 18 ms vs 55 ± 15 ms, P = 0.0002) and corrected QT dispersion (QTcD) (76 ± 18 ms vs 55 ± 15 ms, P = 0.0002) were significantly increased in cases with VT compared with those without VT. Based on logistic regression analysis for MVP cases, in the case of VT, an enhancement in QTcD (P = 0.01) and the mitral anterior leaflet length (P = 0.003) were the independent predictors of VT. Conclusion: Mitral anterior leaflet length and enhanced QTcD are closely related with VT in patients with classical MVP. (PACE 2010; 33:1224,1230) [source]

Electrocardiographic Abnormalities in Young Athletes with Mitral Valve Prolapse

CLINICAL CARDIOLOGY, Issue 8 2009
oskot MD, yna Markiewicz-
Background Mitral valve prolapse (MVP) is the most common primary valvular abnormality in a young population. In some individuals, MVP is silent or associated with palpitations, dizziness, chest pain, and abnormal electrocardiogram (ECG) repolarization with or without ventricular arrhythmias. Hypothesis The aim of the present study was to assess the occurrence of the clinical and electrocardiographic abnormalities in young athletes with silent MVP. Methods A group of 10 children, who have been sport training intensively, with preparticipation silent MVP were examined for symptoms and/or ECG abnormalities. The diagnosis of MVP was made by echocardiography. Results Three athletes were asymptomatic at initial presentation. The other 7 athletes presented with symptoms. The QTc intervals > 440 msec were recorded in 2 athletes (1 with syncope). Abnormal ECG repolarization was found in 7 athletes (4 athletes were symptomatic and 3 were asymptomatic). A large variety of T-waves was registered in athletes who presented with symptoms. In asymptomatic athletes, the tall and flat T-waves were recorded. Conclusions Young athletes with MVP are often predisposed to electrocardiographic abnormalities of ventricular repolarization, which requires annual cardiologic evaluation. Copyright © 2009 Wiley Periodicals, Inc. [source]

Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches: a pilot study

ACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010
C. Termine
Termine C, Trotti R, Ondei P, Gamba G, Montani N, Gamba A, De Simone M, Marni E, Balottin U. Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches: a pilot study. Acta Neurol Scand: 2010: 122: 91,96. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To investigate the prevalence of mitral valve prolapse (MVP) and abnormalities of haemostasis in children and adolescents with migraine with aura (MA) compared with peers affected by other idiopathic headaches. Materials and methods,,, We recruited 20 MA patients (10 men and 10 women; age range 8,17 years) and 20 sex- and age-matched subjects with other idiopathic headaches. Both groups underwent colour Doppler transthoracic echocardiography to detect MVP and the following laboratory work-up: plasma prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, protein C, protein S, homocysteine, lupus anticoagulant, von Willebrand factor (vWF) ristocetin cofactor activity, immunoglobulins (Ig) G and M anticardiolipin antibodies (aCL). Factor V Leiden, factor II and methylenetetrahydrofolate reductase were investigated (we did not test the entire genes, but screened for specific point mutations). Results,,, The prevalence of MVP was significantly higher in the MA subjects than in the patients affected by other idiopathic headaches (40% vs 10%; P < 0.05). Moreover, the MA patients showed a higher rate of above-normal IgM aCL titres (45% vs 10%; P < 0.05). Finally, in the group of patients with MVP we found a higher prevalence of aCL in those with MA compared with those affected by other idiopathic headaches. Conclusions,,, A proportion, at least, of the MA patients showed a more complex phenotype characterized by MVP and/or positive aCL titres. The pathogenetic role of these associations is obscure and larger studies are needed to confirm the usefulness of echocardiographic and laboratory investigations in this area and to identify possible new treatment approaches that might be explored in this group of MA patients. [source]

Electrocardiographic Abnormalities in Young Athletes with Mitral Valve Prolapse

Mitral Valve Prolapse in Marfan Syndrome: An Old Topic Revisited

Asymptomatic Isolated Congenital Left Ventricular Muscular Diverticulum In An Adult: A Case Report

ECHOCARDIOGRAPHY, Issue 2 2003
Guoqian Huang M.D.
Congenital ventricular diverticulum is a very rare malformation in adults. We describe a 21-year-old male with a congenital muscular left ventricular diverticulum in the inferior wall. The lesion was suspected on two-dimensional transthoracic echocardiography; transesophageal echocardiography allowed clear detection of the diverticulum as well of mild mitral valve prolapse. The diagnosis was confirmed by cardiac catheterization. There were no other thoracoabdominal or cardiac anomalies, the patient was asymptomatic, and surgery was not deemed necessary. (ECHOCARDIOGRAPHY, Volume 20, February 2003) [source]

Predictors for Maintenance of Sinus Rhythm after Cardioversion in Patients with Nonvalvular Atrial Fibrillation

ECHOCARDIOGRAPHY, Issue 5 2002
Ökçün M.D.
Recurrence of atrial fibrillation (AF) after cardioversion (CV) to sinus rhythm (SR) is determined by various clinical and echocardiographic parameters. Transesophageal echocardiographic (TEE) parameters have been the focus of clinicians' interests for restoring and maintaining SR. This study determined the clinical, transthoracic, and TEE parameters that predict maintenance of SR in patients with nonvalvular AF after CV. We enrolled 173 patients with nonvalvular AF in the study. TEE could not be performed in 26 patients prior to CV. Twenty-five patients had spontaneously CV prior to TEE. Six patients were excluded because of left atrial (LA) thrombus assessed by TEE. CV was unsuccessful in 6 patients. The remaining 110 consecutive patients (56 men, 54 women, mean age 69 ± 9 years), who had been successfully cardioverted to SR, were prospectively included in the study. Fifty-seven (52%) patients were still in SR 6 months after CV. Age, gender, the configuration of the fibrillation wave on the electrocardiogram, pulmonary venous diastolic flow, and the presence of diabetes, hypertension, coronary artery disease, mitral annulus calcification, and mitral valve prolapse (MVP) did not predict recurrence. Duration of AF, presence of chronic obstructive pulmonary disease (COPD), LA diameter, left ventricular ejection fraction (EF), left atrial appendage peak flow (LAAPF), LAA ejection fraction (LAAEF), pulmonary venous systolic flow (PVSF), and the presence of LA spontaneous echo contrast (LASEC) predicted recurrence of AF 6 months after CV. In multivariate analysis, LAAEF < 30% was found to be the only independent variable (P < 0.0012) predicting recurrence at 6 months after CV in patients with nonvalvular AF. LAAEF more than 30% had a sensitivity of 75% and a specificity of 88% in predicting maintenance of SR 6 months after CV in patients with nonvalvular AF. In conclusion, TEE variables often used to determine thromboembolic risk also might be used to predict the outcome of CV. [source]

Rupture of chordae tendineae in patients with ,-thalassemia

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2004
Dimitrios Farmakis
Abstract: Cardiac disease is the primary cause of mortality in , -thalassemia patients. Except for ventricular dysfunction and pulmonary hypertension that represent the main forms of heart disease in these patients, valvular abnormalities including valvular regurgitation, endocardial thickening and calcification and mitral valve prolapse have also been described. Here we present two patients with thalassemia major and mitral chordal rupture, a previously undescribed abnormality in this population. Pathogenesis of this finding may involve thalassemia-related pseudoxanthoma elasticum-like syndrome, a diffuse elastic tissue defect, which is observed with a notable frequency in these patients and has been associated with numerous cardiovascular complications, including valvular ones. [source]

Feasibility of Myxomatous Mitral Valve Repair Using Direct Leaflet and Chordal Radiofrequency Ablation

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2008
JEFFREY L. WILLIAMS M.D., M.S.
Objective: Minimally invasive repair of mitral valve prolapse (MVP) causing severe mitral regurgitation (MR) should reduce MR and have chronic durability. Our ex vivo, acute in vivo, and chronic in vivo studies suggest that direct application of radiofrequency ablation (RFA) to mitral leaflets and chordae can effect these repair goals to decrease MR. Methods: A total of seven canines were studied to assess the effects of RFA on mitral valve structure and function. RFA was applied ex vivo (n = 1), acutely in vivo using a right lateral thoracotomy and cardiopulmonary bypass (n = 3), and chronically in vivo using percutaneous access to the heart (n = 3). RFA was applied to the mitral valve and its associated chordae. Mitral valve structure and function (in vivo preparations) were then assessed. Results: Ex vivo application of RFA resulted in qualitative reduction in mitral leaflet surface area and chordal length. Acute in vivo application of RFA to canines found to have MVP causing severe MR demonstrated a 43.7,60.7% statistically significant (P = 0.039) reduction in postablation MR. Chronic, in vivo, percutaneous application of RFA was found to be feasible and the engendered alterations durable. Conclusion: These data suggest that myxomatous mitral valve repair using radiofrequency energy delivered via catheter is feasible. [source]

Cardiac involvement in infantile Sandhoff disease

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2002
P Venugopalan
Abstract: An 18-month-old boy with enzyme assay-confirmed infantile Sandhoff disease (MIM 268800) is reported. Besides the classical neurological features, this patient exhibited severe mitral regurgitation secondary to mitral valve prolapse and mild aortic regurgitation from aortic valve prolapse. He also had asymmetric hypertrophy of the interventricular septum without left ventricular outflow tract obstruction. [source]

Anterior Mitral Valve Length is Associated with Ventricular Tachycardia in Patients with Classical Mitral Valve Prolapse

Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches: a pilot study

The genetics of panic disorder: state of the art

ACTA NEUROPSYCHIATRICA, Issue 2 2004
Dirk Van West
Panic disorder (PD) is a highly prevalent, debilitating disorder. The heritability of the disease has been estimated by twin studies to be between 30 and 60%. The vulnerability for PD overlaps with an increased risk of bipolar disorder in some families. Classical genetic methods such as linkage analysis and association studies have not yet identified genetic risk factors beyond doubt. However, two independent studies confirm linkage of a specific syndrome characterized by PD, bladder problems, severe headaches, mitral valve prolapse and thyroid dysfunction to genetic markers on chromosome 13q. Association studies, although showing divergent results, give some support to a causative role for the genes encoding for monoamine oxidase A (MAO-A), cholecystokinin (CCK) and catechol-O-methyltransferase (COMT). Finally, a somatic duplication of a 19-Mb region on chromosome 15 has been associated with PD, but this intriguing finding awaits confirmation. [source]

Outcome of pulmonary and aortic stenosis in Williams-Beuren syndrome in an Asian cohort

ACTA PAEDIATRICA, Issue 6 2007
Ching-Chia Wang
Abstract Aims: To define the cardiovascular anomalies and the long-term outcomes in an Asian cohort with Williams-Beuren syndrome (WBS). Methods: Data were retrieved from a retrospective chart review of patients who had a definitive diagnosis of WBS by fluorescence in situ hybridization between 1995 and 2005. All patients underwent echocardiography every 3,9 months. Ten patients underwent cardiac catheterization. Results: Twenty-one patients with a total follow-up of 134 patient-years (median: 72 months) were enrolled. Characteristic dysmorphic facial features were noted in 19 patients (n = 19, 90%). All except one had associated cardiac anomalies, accounting for 0.3% (20/6640) of the patients with congenital heart disease. The spectrum of cardiac anomalies included supravalvular aortic stenosis (SVAS) (n = 15, 71%), peripheral pulmonary stenosis (PPS) (n = 12, 57%), pulmonary valve stenosis (PS) (n = 10, 47%), mitral valve prolapse (MVP) (n = 9, 43%), coarcation of the aorta (n = 4, 19%), ventricular septal defect (n = 2, 10%) and atrial septal defect (n = 1, 5%). Concurrent SVAS and PS/PPS were found in 14 (70%) patients. Only one patient required balloon dilation of PS, which improved. Regression of the stenoses occurred with a probability of 31, 90 and 71% at the age of 10 years for SAVS, PS and PPS, respectively. Conclusions: Among our WBS patients, SVAS, PPS and PS were common, and were associated with probability of spontaneous regression, especially of right-sided lesions. [source]

Ortnery's syndrome in association with mitral valve prolapse

CLINICAL CARDIOLOGY, Issue 4 2000
C. V. Kishan M.D.
Abstract The case of an 83-year-old woman with a history of hypertension, valvular heart disease, atrial fibrillation, and cardiomegaly is presented. The patient also had progressive hoarseness of her voice and intermittent dysphagia. Ear, nose, and throat examination revealed left vocal cord paralysis. Echocardiography revealed severely dilated left (LA) and right atria (RA), moderate mitral regurgitation, severe tricuspid regurgitation, and prolapse of both these valves. A review of literature of Ortner's or cardiovocal syndrome is presented. Ortner's syndrome due to mitral valve prolapse has not been reported previously. [source]

Infective endocarditis in Greece: a changing profile.

CLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2004
Epidemiological, microbiological, therapeutic data
Abstract The epidemiology, and clinical and microbiological spectrum, of infective endocarditis (IE) in Greece was analysed in a prospective 4-year study in a tertiary hospital and a heart surgery centre in Athens. In total, 101 cases of IE (71 men, 30 women, aged 54.4 ± 17.1 years) were studied, with a follow-up period of 3 months. Seventy-seven cases were definite and 24 possible; 59 involved native valves (native valve endocarditis; NVE), 31 prosthetic valves (prosthetic valve endocarditis; PVE), of which nine were early and 22 late, and 11 permanent pacemakers (pacemaker endocarditis; PME). There was a predominant involvement of aortic (48/101) and mitral (40/101) valves. Seven patients had rheumatic valvular disease, two had mitral valve prolapse, and eight had a previous history of IE. Thirteen and six patients had undergone dental and endoscopic procedures, respectively. In 13 patients, intravenous catheters were used within the 3 months before diagnosis of IE. There were three intravenous drug users among the patients. Staphylococcus aureus was the most important pathogen, isolated in 22% of cases, followed by viridans streptococci (19%) and coagulase-negative staphylococci (16%). Enterococcus spp. were responsible for 3%, HACEK group for 2%, and fungi for 6% of cases. Viridans streptococci were the leading cause of NVE (29%), Staphylococcus epidermidis of PVE (16%), and S. aureus of PME (54.5%). Six of 22 S. aureus and ten of 16 S. epidermidis isolates were methicillin-resistant. Surgical intervention, including total pacemaker removal, was performed in 51.5% of patients. Overall mortality was 16%, but was 29% with PVE, and was significantly higher with medical than with combined surgical and medical therapy (24.5% vs. 8%). Compared with previous studies, there were changing trends in the epidemiology, microbiology, treatment and prognosis of IE in Greece. [source]