title: Long-term site-related differences in the progression and regression of the idiopathic mitral valve prolapse syndrome.
abstract: The natural history of uncomplicated mitral valve prolapse (MVP) is not clearly understood. To determine the site-related differences in regression and progression of MVP, 112 patients with idiopathic MVP were enrolled in this echocardiographic follow-up study. Cardiovascular complications, including dysarrhythmias (n = 3, 2.7%), overt congestive heart failure (n = 4, 3.6%), progression of mitral regurgitation over one grade (n = 28, 25.0%), newly confirmed chordal rupture (n = 1, 0.9%), and surgical repair (n = 2, 1.8%), were observed in these patients during a follow-up period of 1-13 years (mean, 4.0 +/- 2.8 years). Multivariate analysis and Kaplan-Meier analysis revealed that posterior leaflet prolapse and significant mitral regurgitation (grade >/=2) were considerable risks for cardiovascular complications. Regression of MVP was seen in 17 (18.7%) of the anterior prolapse patients; however, new prolapse was observed in 40 (35.7%) patients, mainly in posterior prolapse patients. These results suggest that site-related differences exist in uncomplicated MVP prognosis and that MVP in the posterior leaflet has a poor outcome compared to that in the anterior leaflet.
authors.affiliation: Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Kamei
authors.forename: N
authors.initials: N
authors.lastname: Nakahara
authors.forename: S
authors.initials: S
authors.lastname: Yuda
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Tsuchihashi
authors.forename: K
authors.initials: K
authors.lastname: Shimamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications / Q000000981:diagnostic imaging*; D011379:Prognosis; D012075:Remission, Spontaneous; D014463:Ultrasonography