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Mitral Valve Prolapse in Obstructive Hypertrophic Cardiomyopathy

Changpeng Song1, Jingang Cui1, Xinxin Zheng1

  • 1Departments of Special Medical Treatment Center.

The American Journal of Cardiology
|September 14, 2023
PubMed

Insights

Obstructive hypertrophic cardiomyopathy (oHCM) with mitral valve prolapse (MVP) is rare but linked to worse symptoms. Combined surgery effectively reduces heart obstruction and mitral regurgitation, showing safe outcomes for patients with oHCM and MVP.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Heart Diseases

Background:

  • Obstructive hypertrophic cardiomyopathy (oHCM) and mitral valve prolapse (MVP) can cause heart failure and sudden death.
  • Clinical characteristics and surgical outcomes for patients with co-existing oHCM and MVP are not well-documented.

Purpose of the Study:

  • To investigate the clinical features and surgical outcomes of patients with oHCM and concomitant MVP.
  • To compare outcomes between oHCM patients with and without MVP undergoing septal myectomy.

Main Methods:

  • Retrospective study of 84 patients with oHCM undergoing septal myectomy from April 2012 to February 2018.
  • 28 patients had MVP, and 56 were age- and gender-matched controls without MVP.
  • Data collected from electronic medical records and follow-up surveys.

Main Results:

  • Patients with MVP presented with more severe symptoms (NYHA class III-IV: 96% vs 77%), moderate-to-severe mitral regurgitation (86% vs 48%), atrial fibrillation (39% vs 11%), and ventricular tachycardia (44% vs 15%).
  • MVP patients experienced longer postoperative hospital stays (10.9 vs 7.8 days).
  • Significant reductions in left ventricular outflow tract gradient and mitral regurgitation were observed in both groups post-surgery, with no mortality.

Conclusions:

  • MVP is an infrequent comorbidity in oHCM, associated with increased symptoms, mitral regurgitation, and arrhythmias.
  • Combined septal myectomy and mitral valve surgery are safe and effective for oHCM patients with MVP, significantly improving hemodynamic parameters.

Keywords:
hypertrophic cardiomyopathymitral valve prolapseoutcomes

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