title: Predisposing factors for severe mitral regurgitation in idiopathic mitral valve prolapse.
abstract: To elucidate predisposing factors for severe mitral regurgitation (MR) in idiopathic mitral valve prolapse (MVP), 124 MVP patients were classified into the following categories: 55 with isolated clicks (click group), 35 with a late-systolic murmur (late-SM group), and 34 with a holosystolic murmur (holo-SM group). Their clinical and echocardiographic findings were compared with those of 26 patients with spontaneous chordal rupture (rupture group). In 22 patients in the click group, 24 in the late-SM group, and 22 in the holo-SM group, follow-up studies were performed for a mean of 4.5 years (range 1 to 13.5). The mean age was youngest in the click group and oldest in the rupture group. The click and late-SM groups showed a female predominance, but the holo-SM and rupture groups showed a male predominance. There was no difference in the incidence of systemic hypertension among the 4 groups. Most patients in the click and late-SM groups had anterior leaflet prolapse. In the holo-SM and rupture groups, however, the incidence of posterior leaflet involvement was significantly increased. The incidence of thickened mitral valve increased in order of the click (8%), late-SM (21%), holo-SM (38%), and rupture (50%) groups. Six patients in the holo-SM group developed chordal rupture with severe MR during the follow-up period. In the click and late-SM groups, however, there were no complications and no development into a holo-SM. Thus, aging, male sex, posterior leaflet prolapse, thickened mitral valve, and holo-SM were found to be important predisposing factors for severe MR in idiopathic MVP.
authors.affiliation: Second Department of Internal Medicine, School of Medicine, University of Tokushima, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Fukuda
authors.forename: T
authors.initials: T
authors.lastname: Oki
authors.forename: A
authors.initials: A
authors.lastname: Iuchi
authors.forename: T
authors.initials: T
authors.lastname: Tabata
authors.forename: K
authors.initials: K
authors.lastname: Manabe
authors.forename: Y
authors.initials: Y
authors.lastname: Kageji
authors.forename: M
authors.initials: M
authors.lastname: Sasaki
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.forename: S
authors.initials: S
authors.lastname: Ito
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002815:Chordae Tendineae; D004452:Echocardiography; D005260:Female; D006337:Heart Murmurs / Q000175:diagnosis / Q000209:etiology; D006341:Heart Rupture / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000175:diagnosis; D010701:Phonocardiography; D012307:Risk Factors; D012737:Sex Factors