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Evolución del prolapso de la válvula mitral: conocimientos del estudio del corazón de Framingham

Francesca N Delling¹, Jian Rong², Martin G Larson²

¹From Boston University and National Heart, Lung & Blood Institute's Framingham Heart Study, Framingham, MA (F.N.D., J.R., B.L., E.O., P.S., E.J.B., R.S.V.); Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (F.N.D., D.F., B.H.); Neurology Section in the Department of Medicine, Boston University School of Medicine, MA (J.R.); Department of Mathematics and Statistics, Boston University, MA (M.G.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (W.J.M.); Cardiology (E.J.B., R.S.V.) and Preventive Medicine Sections (E.J.B., R.S.V.), Department of Medicine, Boston University School of Medicine, MA; Department of Epidemiology, Boston University School of Public Health, MA (E.J.B., R.S.V.); and Cardiac Ultrasound Laboratory, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (R.A.L.). fdelling@bidmc.harvard.edu.

|March 24, 2016

Resumen

Las morfologías de prolapso de la válvula mitral no dianostica (MVP) pueden progresar a MVP. Durante 3 a 16 años, la MVP puede provocar una regurgitación mitral significativa en una cuarta parte de los individuos, con cambios en el prospecto que indican progresión.

Área de la Ciencia:

Cardiología
La ecocardiografía
Enfermedad Valvular del Corazón

Sus antecedentes:

Los estudios longitudinales sobre la progresión del prolapso de la válvula mitral (PVM) en la población general son escasos.
Esto incluye a las personas con morfologías MVP no diagnosticadas (NDM).

Objetivo del estudio:

Investigar la progresión longitudinal de los MVP y los NDM.
Para analizar los cambios en la morfología y función de la válvula mitral con el tiempo.

Principales métodos:

261 participantes de Framingham Offspring se sometieron a imágenes al inicio y 3-16 años después.
Las mediciones incluyeron el diámetro anular, el desplazamiento del folleto, el grosor, la altura de la coaptación y la altura del chorro de regurgitación.
Los participantes se clasificaron en MVP, NDM (desplazamiento sistólico mínimo o coaptación anterior anormal) y referentes sanos.

Principales resultados:

Los individuos con MVP mostraron un mayor desplazamiento del prospecto, grosor y altura del chorro en comparación con los referentes.
El 17% de los pacientes con MVP desarrollaron regurgitación mitral moderada/ severa; el 8% se sometió a reparación de la válvula.
El 80% de los NDMs de coaptación anterior anormales progresaron a MVP posterior.
El 34% de los NDM de desplazamiento sistólico mínimo fueron reclasificados como MVP o coaptación anterior anormal.

Conclusiones:

Las morfologías de MVP no dianóstico pueden evolucionar en MVP abierto.
La progresión de MVP a regurgitación mitral significativa ocurre en aproximadamente el 25% de los individuos de más de 3 a 16 años.
Los cambios morfológicos en el prospecto mitral están vinculados tanto a la progresión de la DMN como a la de la PMV.

Palabras clave:

ecocardiografía Ciencias de la salud Válvula mitral

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