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How Prevalent Is Mitral-Valve Prolapse?
Mitral-valve prolapse is considered to be a common disorder frequently associated with serious complications. Although referral-based studies have provided valuable data about mitral-valve prolapse, there is little information available from community-based samples. Between January 1991 and January 1995, investigators evaluated 3,491 subjects from the offspring cohort of the Framingham Heart Study who had technically adequate echocardiograms. Mitral-valve prolapse was diagnosed according to (1) the displacement of the mitral leaflets during systole relative to the line connecting the annular-hingepoints and (2) the thickness of the leaflets. More than 2 mm of displacement and at least 5 mm of maximal thickness indicated classic prolapse; more than 2 mm of displacement but less than 5 mm of maximal thickness indicated nonclassic prolapse.
Forty-seven subjects (1.3 percent) had classic mitral-valve prolapse, and 37 (1.1 percent) had nonclassic mitral-valve prolapse. Age; sex; history of heart failure, atrial fibrillation, or cerebrovascular disease; and symptoms of chest pain and dyspnea were not significantly associated with mitral-valve prolapse. Although subjects with mitral-valve prolapse had a slightly higher degree of mitral regurgitation than those without prolapse, average regurgitation was trace or mild for all subjects. Of subjects with classic prolapse, 7 percent had severe mitral regurgitation compared with 0 percent for nonclassic prolapse and 0.5 percent of those without prolapse.
Comment: This careful community-based study indicates that mitral-valve prolapse and its adverse sequelae are not as prevalent as previously reported. Although this is a cross-sectional study, it provides some of the best information available on mitral-valve prolapse.
— HM Krumholz
Published in Journal Watch Cardiology August 20, 1999
Citation(s):
Freed LA et al. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med 1999 Jul 1 341 1-7.
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