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Genes, gender and geometry and the prolapsing mitral valve
1Department of Cardiovascular Medicine, Prince Henry/Prince of Wales Hospitals, Sydney, NSW, Australia.
Australian and New Zealand Journal of Medicine
|October 1, 1992
Summary
Mitral Valve Prolapse (MVP) has genetic links and is more common in women. However, severe MVP complications like valve regurgitation are more frequent in men over 50, potentially due to higher blood pressure.
Area of Science:
- Cardiology
- Genetics
- Pathology
Background:
- Mitral Valve Prolapse (MVP) affects approximately 4% of the population, often as a benign condition.
- Previous associations with adverse outcomes have been complicated by ascertainment bias.
- Understanding MVP's contributing factors is crucial for managing potential complications.
Purpose of the Study:
- To investigate the roles of genetic, gender, and geometric factors in Mitral Valve Prolapse (MVP).
- To clarify the etiology of adverse outcomes in a subset of MVP patients.
- To differentiate between common MVP and MVP associated with specific connective tissue disorders.
Main Methods:
- Review of existing data on MVP prevalence and associations.
- Analysis of family aggregation patterns to infer inheritance models (dominant vs. polygenic).
- Comparison of MVP prevalence and complication rates between genders and across age groups.
Main Results:
- MVP is linked to dominant inherited connective tissue disorders like Marfan syndrome (85% of affected adults).
- Most MVP cases show family aggregation, suggesting polygenic inheritance.
- MVP is more prevalent in young women (5%) than men (3%), but severe complications (e.g., regurgitation, endocarditis) are 2-3 times more common in men over 50.
Conclusions:
- MVP has diverse etiologies, including specific genetic syndromes and polygenic inheritance.
- Gender influences both prevalence and complication risk in MVP.
- Geometric factors and potential response-to-injury mechanisms may explain progressive valve damage in men.