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Left ventricular dysfunction in symptomatic mitral valve prolapse.

G W Dorn1, A S Gertler, L Gordon

  • 1Cardiovascular Division, Medical University of South Carolina, Charleston.

Chest
|February 1, 1989
PubMed
Summary
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Chest pain in mitral valve prolapse (MVP) patients may stem from abnormal left ventricular function, not just coronary artery disease. Exercise tests showed impaired ventricular response in symptomatic MVP patients.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Nuclear Cardiology

Background:

  • Idiopathic mitral valve prolapse (MVP) can present with chest pain, arrhythmias, and ECG changes mimicking coronary artery disease (CAD).
  • Differentiating chest pain causes in MVP patients is clinically important.

Purpose of the Study:

  • To investigate left ventricular (LV) function response to exercise in patients with MVP and chest pain compared to asymptomatic MVP patients and symptomatic normal controls.
  • To assess the utility of exercise radionuclide ventriculography in distinguishing chest pain etiology in MVP.

Main Methods:

  • Prospective study involving radionuclide cineangiograms (cardiac MRI) before and after stress tests.
  • Comparison of LV ejection fraction (LVEF) changes during exercise across three groups: MVP with chest pain, MVP without chest pain, and symptomatic normal controls.

Related Experiment Videos

Main Results:

  • Patients with MVP, chest pain, and normal coronary arteries showed no significant change in LVEF post-exercise (-0.5 +/- 4%).
  • Asymptomatic MVP patients and symptomatic normal controls exhibited significant LVEF increases after exercise (11.5 +/- 2% and 17.4 +/- 3%, respectively).
  • Symptomatic MVP patients had lower resting LVEF (59 +/- 3%) compared to asymptomatic MVP (76 +/- 5%) and normal controls (70 +/- 3%).

Conclusions:

  • MVP patients with chest pain demonstrate abnormal LV functional response to exercise.
  • Exercise radionuclide ventriculography may not reliably differentiate chest pain caused by MVP from that of coronary artery disease.