Prevalence, progression, and clinical outcomes of mitral valve prolapse: a systematic review and meta-analysis

Area of Science:

• Cardiology
• Clinical Medicine
• Epidemiology

Background:

• Prevalence of mitral valve prolapse (MVP) and its clinical outcomes vary significantly across different populations and age demographics.
• Understanding the natural history and long-term prognosis of MVP is crucial for effective patient management.

Purpose of the Study:

• To determine the prevalence of MVP in the general population, individuals with associated syndromes, and across various age groups.
• To investigate the rate of MVP progression and the incidence of adverse clinical outcomes.

Main Methods:

• A systematic literature search was conducted to identify studies reporting MVP prevalence and outcomes.
• 83 studies, including 47 on non-syndrome-associated MVP (n=992,944) and 31 on syndrome-associated MVP (n=3067), were included.
• 5 studies (n=1287) analyzed mitral regurgitation progression and adverse events.

Main Results:

• The overall prevalence of MVP in the general population was 1.35%, significantly higher in hospital cohorts (8.7%).
• Prevalence varied by age (0.5% in neonates, 1.8% in children, 2.7% in adolescents, 2.0% in adults), with higher rates in older adults (2.87%) versus young adults (0.67%).
• Mitral regurgitation progressed at 5.5 per 100 person-years, with event rates for all-cause mortality, heart failure, and mitral valve intervention at 1.7, 1.0, and 1.2 per 100 person-years, respectively.

Conclusions:

• MVP is a prevalent condition, especially in individuals with genetic syndromes and older age groups, but also occurs in infants.
• MVP-associated mitral regurgitation is progressive, particularly in moderate cases, and is linked to unexplained excess mortality.
• Comprehensive lifelong management strategies are essential for patients with MVP, addressing potential risks and disease progression.