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Further evidence relating mitral-valve prolapse to cerebral ischemic events
Abstract:
Echocardiography demonstrates prolapse of the mitral valve in at least 5 per cent of the population. Since some observations have linked this condition to stroke, we studied its incidence in two groups of patients with cerebral ischemia. The older group contained 141 patients over 45 years of age (mean, 64.7 years) who had transient ischemia or partial stroke. Prolapse was found in eight (5.7 per cent) of these patients and in 10 (7.1 per cent) of 141 age-matched controls. The second group contained 60 patients who had transient ischemia or partial stroke and were under 45 years old (mean 33.9 years). Prolapse was detected in 24 patients (40 per cent) but in only five (6.8 per cent) of 60 age-matched controls (mean age, 33.7 years). The odds ratio, 9.33, was highly significant (P less than 0.001). In six of the 24 patients there were other potential causes for cerebral ischemia leaving 18 whom the only recognizable potential cause was a prolapsing mitral valve (odds ratio, 7.00; P less than 0.001). This study suggests that this entity has a role in cerebral ischemia, at least in younger patients. (N Engl J Med 302:139-144, 1980).
Insights
Mitral valve prolapse, a common condition, is significantly linked to stroke, especially in younger individuals. This study found a strong association between prolapse and cerebral ischemia in patients under 45.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Mitral valve prolapse (MVP) is a common cardiac condition affecting at least 5% of the population.
- Previous observations suggest a potential link between MVP and cerebrovascular events like stroke.
Purpose of the Study:
- To investigate the incidence of mitral valve prolapse in patients experiencing cerebral ischemia.
- To determine if MVP is a risk factor for stroke, particularly in younger adults.
Main Methods:
- Echocardiography was used to diagnose mitral valve prolapse.
- Two groups of patients with cerebral ischemia (transient ischemia or partial stroke) were studied: one over 45 years old and one under 45.
- Age-matched control groups were used for comparison.
Main Results:
- In patients under 45 with cerebral ischemia, MVP was detected in 40% compared to 6.8% in controls (Odds Ratio 9.33, P < 0.001).
- In older patients (>45), the incidence of MVP was similar between those with cerebral ischemia (5.7%) and controls (7.1%).
- In younger patients, MVP was identified as the primary cause of cerebral ischemia in 18 individuals (Odds Ratio 7.00, P < 0.001).
Conclusions:
- Mitral valve prolapse is significantly associated with cerebral ischemia, particularly in patients under 45 years of age.
- MVP should be considered a potential risk factor for stroke in younger populations.
- Further research is warranted to elucidate the mechanisms linking MVP to ischemic events.