[Prevalence and severity of mitral insufficiency and arrhythmia in mitral valve prolapse]

The purpose of this study was to assess, using Doppler-echocardiography and ambulatory electrocardiography in patients with mitral valve prolapse (MPV), the prevalence and severity of mitral regurgitation (MR) and arrhythmias.

Two groups of patients were compared: those with thickening and redundancy of the mitral valve leaflets, chordae lengthening and dilatation of the valvular ring (anatomic MVP; n = 40) and those with the only movement anomaly detected by 2D echocardiogram (functional MVP; n = 80).

Significant (moderate or severe) MR was found in 4 (5%) of the 80 patients with functional MVP and in 20 (50%) of the 40 patients with anatomic MVP (p < 0.01). No significant difference in the prevalence of atrial and ventricular arrhythmias was found between patients with functional MPV without MR and 40 randomly chosen control subjects. Arrhythmias in patients with functional MVP complicated by MR were significantly more prevalent (p < 0.05) than in patients with functional MVP without MR. Patients with anatomic MVP had significantly more frequent and more complex arrhythmias than did patients with functional MVP complicated by MR (p < 0.05). There was no significant difference in the prevalence of frequent and complex ventricular arrhythmias between patients with anatomic MVP and patients with functional MVP complicated by MR of comparable hemodynamic degree.

These results indicate that prevalence of significant (moderate or severe) MR is higher and that frequent and complex arrhythmias are significantly more prevalent in patients with anatomic MVP. The prevalence of frequent and complex arrhythmias is similar in patients with comparable MR, whether the regurgitation is related to anatomic MVP or to functional MVP or not.