Echocardiographic study of left ventricular wall motion in mitral valve prolapse

A distinct late systolic "dip" in ventricular wall motion is described in patients with mitral valve prolapse. Sixty patients were referred because of clinically suspected mitral valve prolapse. Thirty of these patients had M-mode echocardiograms showing mitral valve prolapse. An abnormal late systolic "dip" in posterior wall motion was present at chordal level in 9 of 30 patients with prolapse but none of 27 patients without prolapse. All of these nine patients had late systolic prolapse and greater mean velocity of circumferential fiber shortening than 21 patients with prolapse but without the "dip" at chordal level (1.6 +/- 0.3 vs 1.3 +/- 0.2, p less than 0.02). Two of these nine patients had several episodes of transient cerebral ischemic attacks. Direct mural compression by the posterior chordae is offered as a possible mechanism for this echographic wall motion finding.