Distinctive anthropometric characteristics of women with mitral valve prolapse

We examined the hypothesis that mitral valve prolapse is often associated with an inherited, anthropometrically distinct habitus. Using standard echo- and phonocardiographic techniques, we identified 60 subjects with mitral valve prolapse, 21 first-degree relatives (12 with mitral valve prolapse and nine normal) and a control group of 57 normal women. Patients with "silent" (echo only) mitral valve prolapse or the Marfan syndrome were excluded. Analysis of measurements taken of the first 39 patients and 46 control subjects revealed that, in relation to their height, patients with mitral valve prolapse had narrower anteroposterior chest diameters and longer arm spans than did the women in the control group. Linear discriminant analysis produced the equation: Z = 17.511 + 98.6 (anteroposterior chest diameter/height)--27.3 (arm span/height). Those with mitral valve prolapse tended to score below zero (mean, --0.62), whereas normal subjects tended to score above zero (mean, --0.39; p less than 0.001). The equation was tested prospectively on 53 subjects, including the 21 family members, and correctly classified 75 percent of all unrelated subjects and 86 percent of the family members as normal or having mitral valve prolapse. Both mitral valve prolapse and discriminant classification followed an autosomally dominant pattern of inheritance. We conclude that a significant proportion of patients with mitral valve prolapse have an autosomally dominant, inherited, anthropometrically distinct habitus, suggesting that mitral valve prolapse is only one component of a generalized developmental syndrome.