Idiopathic mitral valve prolapse-analysis by real-time two-dimensional echocardiography

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Mitral valve prolapse (MVP) diagnosis relies on echocardiographic identification of coaptation discrepancies between mitral leaflets.
• MVP affects anterior, posterior, or both mitral leaflets, with specific common locations for prolapse.

Purpose of the Study:

• To investigate the characteristics of mitral valve prolapse diagnosed by echocardiography.
• To explore the relationship between age, prolapse severity, leaflet involvement, and associated conditions like ruptured chordae tendineae and mitral regurgitation.

Main Methods:

• Real-time two-dimensional echocardiography was used to diagnose and characterize mitral valve prolapse in 100 cases.
• Phonocardiograms were utilized to record mitral regurgitant murmurs.
• Cases of ruptured chordae tendineae were also investigated.

Main Results:

• Out of 100 MVP cases, 65 involved the anterior leaflet, 28 the posterior, and 7 both. Common prolapse sites included the posteromedial commissure (anterior leaflet) and posteromedial/anterolateral commissures (posterior leaflet).
• Posterior leaflet prolapse showed an age-related increase and progression in severity, unlike anterior leaflet prolapse.
• Ruptured chordae tendineae cases were frequent in the forties and fifties, suggesting a link to prolapse progression. Severe prolapse correlated with wider prolapse range and mitral regurgitation, with posterior leaflet prolapse posing a higher risk for regurgitation.

Conclusions:

• Mitral valve prolapse characteristics vary by leaflet and show age-dependent progression, particularly for posterior leaflets.
• The common sites of prolapse align with areas prone to chordae tendineae rupture.
• Posterior leaflet prolapse is associated with a greater likelihood of mitral regurgitation, even in mild cases.