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Rupture of Mitral Chordae Tendineae: Adding to the List of Hypertension Complications
  1. Jimmy Jyh-Ming Juang
  1. National Taiwan University Hospital, Taiwan
    1. Shin-Rong Ke
    1. Keelong Hospital, Department of Health Executive Yuan, Keelong, Taiwan
      1. Jiunn-Lee Lin
      1. National Taiwan University Hospital, Taiwan
        1. Juey-Jen Hwang
        1. National Taiwan University Hospital, Taiwan
          1. Kwan-Li Hsu
          1. National Taiwan University Hospital, Taiwan
            1. Fu-Tien Chiang
            1. National Taiwan University Hospital, Taiwan
              1. Chuen-Den Tseng
              1. National Taiwan University Hospital, Taiwan
                1. Yung-Zu Tseng
                1. National Taiwan University Hospital, Taiwan
                  1. Jin-Jer Chen
                  1. National Taiwan University Hospital, Taiwan
                    1. Fu-Chang Hu
                    1. National Taiwan University, Taiwan
                      1. Yung-Tai Lin
                      1. National Taiwan University Hospital, Taiwan
                        1. Ling-Ping Lai (lplai2003{at}ntu.edu.tw)
                        1. National Taiwan University Hospital, Taiwan

                          Abstract

                          Background: Many patients with chordae tendineae rupture (CTR) of the mitral valve have obscure etiologies. We investigated the association between pre-existing hypertension and idiopathic CTR.

                          Methods: We identified 494 patients with CTR by searching the computer database. For each patient with idiopathic CTR, we included three matched controls without CTR who was admitted to the same hospital for bone fractures.

                          Results: Among the 494 patients with CTR; 351 patients (71%) had idiopathic CTR and 143 patients (29%) had secondary CTR. The prevalence of pre-existing hypertension was significantly higher in the idiopathic than in the secondary CTR group (50.9% vs 14.6%, P<0.001). The odds ratio was 6.0 (95% CI, 3.6-10.1). The percentage of patients without adequate blood pressure control was also higher in the idiopathic than in the secondary CTR group (23.1% vs 4.9%, P<0.001). When compared with the fracture group, patients with idiopathic CTR also had a significantly higher prevalence of hypertension (50.9% vs 14.9%, P<0.001) and the odds ratio was 5.9 (95% CI, 4.5-7.8). After correction for age, the odds ratio of having hypertension was 3.6 (95% CI, 2.1 to 6.3) and 6.6 (P<0.001, 95% CI, 5.0-8.8) when compared with the secondary CTR group and fracture group respectively.

                          Conclusions: We demonstrated a strong association between pre-existing hypertension and idiopathic CTR. Whether or not this disease can be prevented by controlling hypertension deserves further investigation.

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