title: Fibromuscular dysplasia of small coronary arteries and fibrosis in the basilar ventricular septum in mitral valve prolapse.
abstract: The mechanism of sudden cardiac death in patients with mitral valve prolapse is poorly understood. Twenty-four hearts from patients with mitral valve prolapse who suddenly died (mean age 34 +/- 8 years) and 16 trauma control hearts (mean age 30 +/- 7 years) were histologically studied. Dysplasia of the atrioventricular nodal artery was present in 18 of 24 hearts with mitral valve prolapse and four of 16 controls hearts (p = 0.003). The degree of luminal narrowing, as morphometrically measured, was significantly greater in hearts with mitral valve prolapse (p = 0.003). The degree of fibrosis in the base of the ventricular septum, as calculated by computerized morphometry, was greater in hearts with mitral valve prolapse (p = 0.0002) and independent of age, sex, and heart weight (p = 0.005). We conclude that arterial dysplasia in mitral valve prolapse may contribute to sudden cardiac death mediated by ventricular fibrosis.
authors.affiliation: Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Burke
authors.forename: A
authors.initials: A
authors.lastname: Farb
authors.forename: A
authors.initials: A
authors.lastname: Tang
authors.forename: J
authors.initials: J
authors.lastname: Smialek
authors.forename: R
authors.initials: R
authors.lastname: Virmani
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000473:pathology; D004719:Endomyocardial Fibrosis / Q000150:complications / Q000473:pathology*; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications*; D006346:Heart Septum / Q000033:anatomy & histology / Q000473:pathology*; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000473:pathology; D006801:Humans; D008297:Male; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000473:pathology