High Prevalence of Scoliosis in Children with Mitral Valve Prolapse

This study aims to evaluate the prevalence and characteristics of scoliosis in asthenic children diagnosed with mitral valve prolapse (MVP).

This study aims to characterize scoliosis prevalence and examine relationships with mitral valve morphology, regurgitation severity, and skeletal phenotypes (pectus excavatum, hypermobility, skin laxity) in asthenic children with primary MVP based on echocardiographic findings. Individuals with known systemic connective tissue disorders were excluded. Scoliosis was assessed radiographically using Cobb angle measurements with a threshold of ≥10° for diagnosis. Statistical analysis was performed using SPSS 26.0.

The study included 49 asthenic children (25 females, 24 males) aged 9 to 17 years who were diagnosed MVP. The mean age of participants was 13.2 ± 2.2 years. Physical examination revealed pectus excavatum in 46.9%, joint hypermobility in 39%, and skin laxity in 16.3% of patients. Scoliosis (Cobb ≥10°): 47% (23/49, [95% CI: 33-61%]); potential scoliosis (5-10°): 27% (13/49, [95% CI: 16-40%]); any abnormal curvature: 73% (36/49, [95% CI: 59-84%]). Valve morphology: diffuse thickening 61% (30/49); localized elongation 39% (19/49). No significant association between scoliosis and valve morphology (p > 0.05) or MR severity (p > 0.05). Pectus excavatum significantly associated with elongated valve structure (p = 0.001). Pectus excavatum was significantly more common in patients with an elongated, straight valve structure (p = 0.001).

High scoliosis prevalence (47%) in asthenic MVP children is independent of cardiac severity, suggesting intrinsic skeletal tissue vulnerability. Neuroendocrine and immune mechanistic investigation warranted.