Comparison of cardiac findings in patients with mitral valve prolapse who die suddenly to those who have congestive heart failure from mitral regurgitation and to those with fatal noncardiac conditions

1992 ◽  
Vol 70 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Andrew Farb ◽  
Anita L. Tang ◽  
James B. Atkinson ◽  
William F. McCarthy ◽  
Renu Virmani
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Prolapse

scholarly journals Replacement Myocardial Fibrosis in Patients with Mitral Valve Prolapse: Relation to Mitral Regurgitation, Ventricular Remodeling and Arrhythmia

Circulation ◽  
2021 ◽  
Author(s):  
Anne-Laure Constant Dit Beaufils ◽  
Olivier Huttin ◽  
Antoine Jobbe-Duval ◽  
Thomas Senage ◽  
Laura Filippetti ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Ventricular Arrhythmia ◽  
Myocardial Fibrosis ◽  
Mitral Valve Prolapse ◽  
Cardiovascular Events ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Arterial Embolism

Background: Mitral valve prolapse (MVP) is a frequent disease that can be complicated by mitral regurgitation (MR), heart failure, arterial embolism, rhythm disorders and death. Left ventricular (LV) replacement myocardial fibrosis, a marker of maladaptive remodeling, has been described in patients with MVP, but the implications of this finding remain scarcely explored. We aimed at assessing the prevalence, pathophysiological and prognostic significance of LV replacement myocardial fibrosis through late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) in patients with MVP. Methods: Four hundred patients (53±15 years, 55% male) with MVP (trace to severe MR by echocardiography) from 2 centers, who underwent a comprehensive echocardiography and LGE CMR, were included. Correlates of replacement myocardial fibrosis (LGE+), influence of MR degree, and ventricular arrhythmia were assessed. The primary outcome was a composite of cardiovascular events (cardiac death, heart failure, new-onset atrial fibrillation, arterial embolism, and life-threatening ventricular arrhythmia). Results: Replacement myocardial fibrosis (LGE+) was observed in 110 patients (28%; 91 myocardial wall including 71 basal inferolateral wall, 29 papillary muscle). LGE+ prevalence was 13% in trace-mild MR, 28% in moderate and 37% in severe MR, and was associated with specific features of mitral valve apparatus, more dilated LV and more frequent ventricular arrhythmias (45 vs 26%, P<0.0001). In trace-mild MR, despite the absence of significant volume overload, abnormal LV dilatation was observed in 16% of patients and ventricular arrhythmia in 25%. Correlates of LGE+ in multivariable analysis were LV mass (OR 1.01, 95% CI [1.002-1.017], P=0.009) and moderate-severe MR (OR: 2.28, 95% CI [1.21-4.31], P=0.011). LGE+ was associated with worse 4-year cardiovascular event-free survival (49.6±11.7 in LGE+ vs 73.3±6.5% in LGE-, P<0.0001). In a stepwise multivariable Cox model, MR volume and LGE+ (HR: 2.6 [1.4-4.9], P=0.002) were associated with poor outcome. Conclusions: LV replacement myocardial fibrosis is frequent in patients with MVP, is associated with mitral valve apparatus alteration, more dilated LV, MR grade, ventricular arrhythmia, and is independently associated with cardiovascular events. These findings suggest a MVP-related myocardial disease. Finally, CMR provides additional information to echocardiography in MVP.

scholarly journals Mitral regurgitation in Dachshund dogs without heart murmurs

2017 ◽  
Vol 61 (3) ◽  
pp. 363-366
Author(s):  
Magdalena Garncarz ◽  
Marta Parzeniecka-Jaworska ◽  
Magdalena Hulanicka ◽  
Michał Jank ◽  
Olga Szaluś-Jordanow ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Prolapse ◽  
Mitral Valve Disease ◽  
Mitral Valve Regurgitation ◽  
Valve Disease ◽  
Valve Regurgitation ◽  
Heart Murmurs ◽  
Few Data

Abstract Introduction: Older small breed dogs are considered at risk for heart failure secondary to chronic mitral valve disease. However, few data are available on the onset of this disease in such dogs. This study was performed to determine if auscultation alone can be used to eliminate clinically relevant mitral valve regurgitation seen in echocardiography in Dachshund dogs. Material and Methods: Clinical and echocardiographic data were obtained from 107 dogs without heart murmurs. Results: The study revealed that 63.6% of the dogs had mitral regurgitation. Numbers increased with age and a larger percentage of male Dachshunds were affected than female Dachshunds. Mitral valve prolapse and thickening were mild, and the regurgitant area inextensive in most dogs. Conclusions: The study shows that mitral valve regurgitation is prevalent (63.6%) in Dachshunds without heart murmurs. Typical lesions often become apparent during echocardiographic examinations in dogs under 5 years of age.

Anomalous mitral arcade leading to congenital mitral insufficiency with an associated anomaly of the tricuspid valve

1992 ◽  
Vol 2 (4) ◽  
pp. 357-358 ◽  
Author(s):  
Jyoti V. Mandke ◽  
Vikas R. Dharnidharka ◽  
Vasundhara P. Sanzgiri
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Tricuspid Valve ◽  
Acute Onset ◽  
Mitral Insufficiency

SummaryA 21-day-old girl presented with congestive heart failure of acute onset and Doppler evidence of mitral regurgitation, which subsequently proved fatal. Necropsy revealed an anomalous arcade lesion of the mitral valve. The tendinous cords of the tricuspid valve were also abnormal, a finding, to the best of our knowledge, not reported before.

Von Willebrand Factor and Mitral Valve Prolapse

1988 ◽  
Vol 60 (02) ◽  
pp. 230-231 ◽  
Author(s):  
P Froom ◽  
T Margulis ◽  
E Grenadier ◽  
A Palant ◽  
M David ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Mitral Valve ◽  
Von Willebrand Factor ◽  
Mitral Valve Prolapse ◽  
Chordae Tendineae ◽  
The Mean ◽  
Low Levels ◽  
Von Willebrand ◽  
Willebrand Factor

SummaryThe levels of von Willebrand factor (vWF: Ag) were measured in 27 patients with mitral valve prolapse (MVP) and compared to 27 age matched controls. Decreased levels of vWF:Ag (<80%) were found in 59% (16/27) of those with MVP compared to only 7% (2/27) of the controls (p <0.001). Mean vWF: Ag levels were also significantly lower in those with MVP (68 ± 30% versus 100 ± 23%, p <0.001). In those with MVP and congestive heart failure secondary to ruptured chordae tendineae, however, the mean level of vWF:Ag was not significantly different from control values (95 ± 32). There was an increased incidence of recurrent nose bleeds in those with MVP and low levels of vWF: Ag. We conclude that there is a relationship between MVP and low levels of vWF:Ag which may explain the increased incidence of epistaxis in such patients. Increased release of vWF: Ag in those with MVP and concomitant congestive heart failure may account for the normal levels found in this subgroup.

scholarly journals P627 Step by step valve destruction in infective endocarditis with no apparent vegetations

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Skafar ◽  
A Ovsenik ◽  
J Toplisek ◽  
B Berlot ◽  
M Bervar
Keyword(s):  
Heart Failure ◽  
Staphylococcus Aureus ◽  
Congestive Heart Failure ◽  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Antibiotic Therapy ◽  
Systolic Dysfunction ◽  
Illustrative Case ◽  
Posterior Leaflet

Abstract Background Infective endocarditis can present without evident vegetation, diagnosis is challenging and prognosis very poor. We present an illustrative case where natural evolution of the mitral valve destruction with no evident vegetations was followed with frequent consecutive transthoracic (TTE) and transesophageal echocardiography (TOE). Case presentation 71-year old male with known dilated cardiomyopathy presented with dyspnoea, ankle swelling and severe kidney failure with hyperkalemia. During short hospitalization he was recompensated with haemodialysis, parenteral diuretics and inotropes. TTE showed dilated left ventricle with severe systolic dysfunction and no evidence of valvular disease. Few days after discharge he was readmitted with malaise and febrile state with no obvious site of infection. Blood cultures were positive for Staphylococcus aureus and antibiotic therapy was initiated immediately. Weekly TTEs and TOEs were performed (Figure 1, column A-D): Week 1: TTE was performed due to congestive heart failure. There was no suspicion on disease and TTE showed no obvious mitral valve pathology. Week 3: Second TTE showed only light thickening of posterior mitral leaflet with mild mitral regurgitation. Week 4: Follow-up TOE was performed showing posterior leaflet discontinuity with small eccentric regurgitation jet and no vegetation. Week 6: Symptoms of congestive heart failure persisted despite antibiotic treatment. A progressive destruction of posterior leaflet with evident perforation of P1 scallop and consequent severe mitral regurgitation. Patient was referred for urgent mitral valve replacement. Conclusions Staphylococcus aureus is a destructive pathogen and can cause severe destruction of native valve even without obvious vegetations. This case presents echocardiographic features of natural course of infective endocarditis on mitral valve. Despite antibiotic therapy progressive valve destruction is possible. Abstract P627 Figure.

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