title: Lack of association between mitral valve prolapse and history of rheumatic fever.
abstract: To determine whether rheumatic fever is associated with mitral valve prolapse (MVP) diagnosed by echocardiography, records from 561 subjects participating in a prospective family study were reviewed. The prevalence of a history of rheumatic fever by modified Jones criteria was determined in 92 probands and 112 affected relatives or spouses with M-mode and two-dimensional echocardiographic findings of MVP, accompanied in most instances by classic auscultatory findings, and in 357 family members without MVP. The prevalence of rheumatic fever was 5.4% in both MVP sub-groups and 2.2% in the family members without MVP (p<0.05 vs the combined MVP group). However, people with a history of rheumatic fever were older than the remaining subjects (48 +/- 17 vs 36 +/- 20 years, p<0.01) as expected because of the decline in rheumatic fever in the twentieth century, and subjects with MVP were older than subjects without MVP (39 +/- 16 vs 34 +/- 22 years, p<0.01). Multiple logistic regression showed that after the independent relation of older age with a positive history of rheumatic fever (p<0.01) was taken into account, there was a trend toward a lower likelihood of previous rheumatic fever associated with MVP (odds ration 0.42, p=0.07). These results do not support either a true association or a causal role of rheumatic fever in the pattern of mitral leaflet motion and auscultatory abnormalities in adults, for which the term MVP is generally used.
authors.affiliation: Department of Medicine, The New York Hospital-Cornell Medical Center, New York 10021, USA.
authors.forename: A
authors.initials: A
authors.lastname: Zuppiroli
authors.forename: M J
authors.initials: MJ
authors.lastname: Roman
authors.forename: M
authors.initials: M
authors.lastname: O'Grady
authors.forename: R B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000328:Adult; D017677:Age Distribution; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology