Valvular heart diseaseRisk, Determinants, and Outcome Implications of Progression of Mitral Regurgitation After Diagnosis of Mitral Valve Prolapse in a Single Community
Section snippets
Methods
Medical care in Olmsted County, Minnesota, is self-contained in the community, and the echocardiographic laboratory at our institution is the only provider of echocardiographic services in the county. Moreover, our institution is connected to all other potential medical care facilities in Olmsted County by the Rochester Epidemiology Project.5 It was therefore possible to identify all 803 residents of Olmsted County with a first diagnosis of MVP confirmed by echocardiography from January 1,
Results
From January 1, 1989, to December 31, 1998, 285 residents of Olmsted County diagnosed at our institution with MVP and with MR absent, mild, or moderate at diagnosis returned for repeat echocardiography during follow-up and were therefore included in this study. Indications for initial echocardiography were as follows: congestive heart failure or class III or IV symptoms in 23 patients (8%), ischemic neurologic events in 19 patients (7%), atrial fibrillation in 22 patients (8%), minor cardiac
Discussion
The present study included patients diagnosed in the community with a uniform cause of MR (i.e., MVP) and with various grades of MR, including none. These patients were followed up in the community, reflecting routine practice in mitral valve disease monitoring. Under these routine circumstances, our study showed that on average, the degree of MR increases with time and that MR progression is associated with progressive left ventricular and atrial remodeling and with poor outcomes. This
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Cited by (52)
The Mitral Annular Disjunction of Mitral Valve Prolapse: Presentation and Outcome
2021, JACC: Cardiovascular ImagingValve Strain Quantitation in Normal Mitral Valves and Mitral Prolapse With Variable Degrees of Regurgitation
2021, JACC: Cardiovascular ImagingCitation Excerpt :The mitral prolapse substudy of the Framingham Heart Study demonstrated a strong relation of valve thickness to clinical worsening of initially nondiagnostic MVP morphologies that can evolve to diagnostic MVP over a 3- to 16-year period, confirming the importance of identifying minimal MVP expression (43). These structural histological associations with prognosis (31,40,42,43) are of particular importance in that they theoretically offer the current missing link tying clinical strain data to long-term outcome, be it disease progression or complications. Now that the methodology is available for strain quantitation, longitudinal prospective studies are needed to assess the prognostic impact of MV strain calculation in patients with MVP.
Presentation and Outcome of Arrhythmic Mitral Valve Prolapse
2020, Journal of the American College of CardiologyPredictors of Progression in Patients With Stage B Aortic Regurgitation
2019, Journal of the American College of CardiologyCitation Excerpt :Nonetheless, our result cannot be interpreted as blood pressure control in AR is not important. Analogous to MR (16), baseline AR severity was powerful in predicting AR progression, supporting different intervals for follow-up according to baseline AR severity (i.e., moderate AR requires shorter follow-up) (3). In addition to guideline recommendations (i.e., that mild and moderate AR be followed every 3 to 5 years and 1 to 2 years, respectively), which did not address patients with mild-to-moderate AR, we propose that those with baseline trivial/mild, mild-to-moderate, and moderate AR be followed whenever symptoms change, or every 5, 3, and 1 years, respectively.
Mitral Valve Prolapse: Multimodality Imaging and Genetic Insights
2017, Progress in Cardiovascular Diseases