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DEFINING GROUPS AT RISK FOR COMPLICATIONS OF MITRAL- VALVE PROLAPSE.

With improvements in diagnostic techniques, particularly ultrasonography, mitral-valve prolapse (MVP) can now be diagnosed more reliably. Prior studies have suggested that certain subgroups of patients with MVP are at particular risk for complications. In this retrospective study, the authors used ultrasound diagnostic techniques to compare complications in 319 MVP patients with thickening of the valve leaflets and redundancy ("classic" MVP) and 137 MVP patients without valve thickening ("nonclassic" MVP).

The following complications were found significantly more often in the classic than the nonclassic group: infective endocarditis (3.5 vs. 0 percent), moderate to severe mitral regurgitation (12 vs. 0 percent), and the need for mitral- valve replacement (6.6 vs. 0.7 percent). The frequency of stroke, however, was similar in the two groups (7.5 vs. 5.8 percent). Sudden death was not reported in either group.

This study was limited because it did not control for interventions (such as antiplatelet or antibiotic therapy) in the two groups; also, some complications might not have come to the authors' attention. However, it is in line with other studies that suggest that patients with MVP are at risk for complications if they have thickened valve leaflets. Prior studies also suggest that male sex and age older than 45 are risk factors.

— ALK

Published in Journal Watch General Medicine April 28, 1989

Citation(s):

Devereux RB. Diagnosis and prognosis of mitral-valve prolapse. N Engl J Med 1989 Apr 20 320 1077-1079.

• Medline abstract (Free)

Marks AR et al. Identification of high-risk and low-risk subgroups of patients with mitral-valve prolapse. N Engl J Med 1989 Apr 20 320 1031-1036.

• Medline abstract (Free)