title: Mitral Valve Prolapse, Psychoemotional Status, and Quality of Life: Prospective Investigation in the Current Era.
abstract: The purpose of this study is to investigate whether mitral valve prolapse is associated with the patient's psychoemotional status and health-related quality of life.
  
  
  
  Mitral valve prolapse and mitral regurgitation were prospectively and comprehensively assessed in 281 patients (age 61 ± 13 years; 63% men); 216 patients with mitral valve prolapse were compared with 65 without mitral valve prolapse (of similar age and sex). Simultaneously, we assessed the patient's psychoemotional status (anxiety, depression, posttraumatic stress symptoms), health-related quality of life, and perceived severity of illness using validated questionnaires.
  
  
  
  Twenty-nine percent of the patients had either no or mild mitral regurgitation (area of effective regurgitant orifice ≤0.2), and 71% had clinically significant mitral regurgitation (moderate/severe). Stratifying patients into no/mild vs moderate/severe mitral regurgitation revealed no differences in psychoemotional status or mental health-related quality of life between patients with mitral valve prolapse vs those without mitral valve prolapse within each subgroup; no/mild mitral regurgitation and moderate/severe mitral regurgitation (all P ≥ .5). In multivariate analysis, mitral valve prolapse was not independently associated with psychoemotional status or health-related quality of life (all P ≥ .4). In addition, while objective severity of the illness was not related to psychoemotional status or health-related quality of life (all P ≥ .2), the patient's perceived severity of illness predicted in and of itself all psychoemotional (all P < .03) and quality-of-life outcomes (all P < .003).
  
  
  
  Mitral valve prolapse is not a determinant of the patient's psychoemotional status or quality of life. Psychoemotional status and health-related quality of life are determined by the patient's perception of the severity of the mitral valve disease, rather than by the presence of mitral valve prolapse.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn; The Engelberg Center for Children and Youth, JDC-Myers-Brookdale Institution, Jerusalem, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Bayer-Topilsky
authors.affiliation: Thoracic & Cardiovascular Surgery at Cleveland Clinic, Abu Dhabi, United Arab Emirates.
authors.forename: Rakesh M
authors.initials: RM
authors.lastname: Suri
authors.affiliation: Department of Cardiology, Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Yan
authors.initials: Y
authors.lastname: Topilsky
authors.affiliation: Department of Industrial Engineering and Management, ORT Braude College of Engineering, Karmiel, Israel.
authors.forename: Yariv N
authors.initials: YN
authors.lastname: Marmor
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.
authors.forename: Max R
authors.initials: MR
authors.lastname: Trenerry
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Antiel
authors.affiliation: Section of Biostatistics, Mayo Clinic, Rochester, Minn.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Mahoney
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn. Electronic address: sarano.maurice@mayo.edu.
authors.forename: Maurice
authors.initials: M
authors.lastname: Enriquez-Sarano
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D016022:Case-Control Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000523:psychology*; D008945:Mitral Valve Prolapse / Q000523:psychology*; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Patient care; Symptoms; Valve disease; Well-being