Natural history of mitral valve prolapse.
To assess the rate and predictors of complications in patients with mitral valve prolapse (MVP), 316 subjects (mean age 42 +/- 15 years) with echocardiographic MVP were followed prospectively for a mean of 102 months: 220 (70%) were women, 225 (71%) had clinically recognized MVP, and 91 (29%) were detected in family studies. During follow-up, 11 patients (0.4/100 subject-years) required mitral valve surgery, 6 died of cardiac causes (0.2/100 subject-years), 7 developed cerebral ischemia (0.3/100 subject-years), and 2 developed active infective endocarditis (0.1/100 subject-years). The overall rate of fatal and nonfatal complications (1/100 patient-years) was higher in men than in women (odds ratio [OR] 3.2, p < 0.003), in subjects aged > 45 than < or = 45 years (OR 3.4, p = 0.002), in clinically recognized patients than in affected family members (OR 3.8, p < 0.02), and in those with a holosystolic murmur (OR 26.9, p < 0.00005); the overall rate was lower in those with a midsystolic click (OR 0.3, p < 0.002). Echocardiographic left ventricular or atrial diameter > or = 6.0 or > or = 4.0 cm, respectively, was associated with a 16.7- and 15.1-fold higher likelihood, respectively, of subsequent complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Zuppiroli
A
A
Department of Medicine, New York Hospital-Cornell Medical Center, New York 10021, USA.
Rinaldi
M
M
Kramer-Fox
R
R
Favilli
S
S
Roman
M J
MJ
Devereux
R B
RB
D000328:Adult; D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000209:etiology; D016009:Chi-Square Distribution; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000000981:diagnostic imaging; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors