We determined the long-term prognosis for patients with mitral-valve prolapse documented by echocardiography by following 237 minimally symptomatic or asymptomatic patients for a mean of 6.2 years (range, 1 to 10.4). The actuarial eight-year probability of survival was 88 per cent, which is not significantly different from that for a matched control population. An initial left ventricular diastolic dimension exceeding 60 mm was the best echocardiographic predictor of the subsequent need for mitral-valve replacement (17 patients). Of the 97 patients with redundant mitral-valve leaflets identified echocardiographically, 10 (10.3 per cent) had sudden death, infective endocarditis, or a cerebral embolic event; in contrast, of the 140 patients with nonredundant valves, only 1 (0.7 per cent) had such complications (P less than 0.001). Most patients with echocardiographic evidence of mitral-valve prolapse have a benign course, but subsets at high risk for the development of progressive mitral regurgitation, sudden death, cerebral embolic events, or infective endocarditis can be identified by echocardiography.
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[Abstract][Full Text]
Nesta, F., Leyne, M., Yosefy, C., Simpson, C., Dai, D., Marshall, J. E., Hung, J., Slaugenhaupt, S. A., Levine, R. A.
(2005). New Locus for Autosomal Dominant Mitral Valve Prolapse on Chromosome 13: Clinical Insights From Genetic Studies. Circulation
112: 2022-2030
[Abstract][Full Text]
Kahaly, G. J., Dillmann, W. H.
(2005). Thyroid Hormone Action in the Heart. Endocr. Rev.
26: 704-728
[Abstract][Full Text]
Zheng, H., Zhan, H., Enriquez-Sarano, M., Schaff, H. V., Tajik, A. J.
(2005). Surgery for Asymptomatic Mitral Regurgitation. NEJM
352: 2245-2246
[Full Text]
Maron, B. J., Ackerman, M. J., Nishimura, R. A., Pyeritz, R. E., Towbin, J. A., Udelson, J. E.
(2005). Task Force 4: HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. J Am Coll Cardiol
45: 1340-1345
[Full Text]
Salem, D. N., Stein, P. D., Al-Ahmad, A., Bussey, H. I., Horstkotte, D., Miller, N., Pauker, S. G.
(2004). Antithrombotic Therapy in Valvular Heart Disease--Native and Prosthetic: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 457S-482S
[Abstract][Full Text]
Avierinos, J.-F., Brown, R. D., Foley, D. A., Nkomo, V., Petty, G. W., Scott, C., Enriquez-Sarano, M.
(2003). Cerebral Ischemic Events After Diagnosis of Mitral Valve Prolapse: A Community-Based Study of Incidence and Predictive Factors. Stroke
34: 1339-1344
[Abstract][Full Text]
Pellerin, D, Brecker, S, Veyrat, C
(2002). Degenerative mitral valve disease with emphasis on mitral valve prolapse. Heart
88: iv20-28
[Full Text]
Freed, L. A., Benjamin, E. J., Levy, D., Larson, M. G., Evans, J. C., Fuller, D. L., Lehman, B., Levine, R. A.
(2002). Mitral valve prolapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol
40: 1298-1304
[Abstract][Full Text]
Sutton, M. S. J., Weyman, A. E.
(2002). Mitral Valve Prolapse Prevalence and Complications: An Ongoing Dialogue. Circulation
106: 1305-1307
[Full Text]
Avierinos, J.-F., Gersh, B. J., Melton, L. J. III, Bailey, K. R., Shub, C., Nishimura, R. A., Tajik, A. J., Enriquez-Sarano, M.
(2002). Natural History of Asymptomatic Mitral Valve Prolapse in the Community. Circulation
106: 1355-1361
[Abstract][Full Text]
Priori, S.G., Aliot, E., Blomstrom-Lundqvist, C., Bossaert, L., Breithardt, G., Brugada, P., Camm, A.J., Cappato, R., Cobbe, S.M., Di Mario, C., Maron, B.J., McKenna, W.J., Pedersen, A.K., Ravens, U., Schwartz, P.J., Trusz-Gluza, M., Vardas, P., Wellens, H.J.J., Zipes, D.P.
(2001). Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J
22: 1374-1450
Zouridakis, E. G., Parthenakis, F. I., Kochiadakis, G. E., Kanoupakis, E. M., Vardas, P. E.
(2001). QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness. Europace
3: 292-298
[Abstract]
Salem, D. N., Hartnett Daudelin, D., Levine, H. J., Pauker, S. G., Eckman, M. H., Riff, J.
(2001). Antithrombotic Therapy in Valvular Heart Disease. Chest
119
: 207S-219S
[Full Text]
Pedersen, H. D., Haggstrom, J.
(2000). Mitral valve prolapse in the dog: a model of mitral valve prolapse in man. Cardiovasc Res
47: 234-243
[Full Text]
Stefanadis, C., Toutouzas, P.
(2000). Mitral valve prolapse: The Merchant of Venice or Much Ado About Nothing ?. Eur Heart J
21: 255-258
Grigioni, F., Enriquez-Sarano, M., Ling, L. H., Bailey, K. R., Seward, J. B., Tajik, A. J., Frye, R. L.
(1999). Sudden death in mitral regurgitation due to flail leaflet. J Am Coll Cardiol
34: 2078-2085
[Abstract][Full Text]
Freed, L. A., Levy, D., Levine, R. A., Larson, M. G., Evans, J. C., Fuller, D. L., Lehman, B., Benjamin, E. J.
(1999). Prevalence and Clinical Outcome of Mitral-Valve Prolapse. NEJM
341: 1-7
[Abstract][Full Text]
Gilon, D., Buonanno, F. S., Joffe, M. M., Leavitt, M., Marshall, J. E., Kistler, J. P., Levine, R. A.
(1999). Lack of Evidence of an Association between Mitral-Valve Prolapse and Stroke in Young Patients. NEJM
341: 8-13
[Abstract][Full Text]
Nishimura, R. A., McGoon, M. D.
(1999). Perspectives on Mitral-Valve Prolapse. NEJM
341: 48-50
[Full Text]
David, T. E., Omran, A., Armstrong, S., Sun, Z., Ivanov, J.
(1998). Long-term results of mitral valve repair for myxomatous disease with and without chordal replacement with expanded polytetrafluoroethylene sutures. J. Thorac. Cardiovasc. Surg.
115: 1279-1283
[Abstract][Full Text]
Dajani, A. S., Taubert, K. A., Wilson, W., Bolger, A. F., Bayer, A., Ferrieri, P., Gewitz, M. H., Shulman, S. T., Nouri, S., Newburger, J. W., Hutto, C., Pallasch, T. J., Gage, T. W., Levison, M. E., Peter, G., Zuccaro, G. Jr
(1997). Prevention of Bacterial Endocarditis : Recommendations by the American Heart Association. Circulation
96: 358-366
[Abstract][Full Text]
Dajani, A. S., Taubert, K. A., Wilson, W., Bolger, A. F., Bayer, A., Ferrieri, P., Gewitz, M. H., Shulman, S. T., Nouri, S., Newburger, J. W., Hutto, C., Pallasch, T. J., Gage, T. W., Levison, M. E., Peter, G., Zuccaro, G. Jr
(1997). Prevention of Bacterial Endocarditis: Recommendations by the American Heart Association. JAMA
277: 1794-1801
[Abstract]
Cheitlin, M. D., Alpert, J. S., Armstrong, W. F., Aurigemma, G. P., Beller, G. A., Bierman, F. Z., Davidson, T. W., Davis, J. L., Douglas, P. S., Gillam, L. D., Lewis, R. P., Pearlman, A. S., Philbrick, J. T., Shah, P. M., Williams, R. G., Ritchie, J. L., Cheitlin, M. D., Eagle, K. A., Gardner, T. J., Garson, A. Jr, Gibbons, R. J., Lewis, R. P., O'Rourke, R. A., Ryan, T. J.
(1997). ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography. Circulation
95: 1686-1744
[Full Text]
Etchells, E., Bell, C., Robb, K.
(1997). Does This Patient Have an Abnormal Systolic Murmur?. JAMA
277: 564-571
[Abstract]
(1997). Survivors of Out-of-Hospital Cardiac Arrest With Apparently Normal Heart: Need for Definition and Standardized Clinical Evaluation. Circulation
95: 265-272
[Abstract][Full Text]
David, T. E.
(1995). Update on Mitral Valve Repair. Ann. Thorac. Surg.
59: 1257-1258
[Full Text]
Orencia, A. J., Petty, G. W., Khandheria, B. K., Annegers, J. F., Ballard, D. J., Sicks, J. D., O'Fallon, W. M., Whisnant, J. P.
(1995). Risk of Stroke With Mitral Valve Prolapse in Population-Based Cohort Study. Stroke
26: 7-13
[Abstract][Full Text]
Cohn, L. H., Couper, G. S., Aranki, S. F., Rizzo, R. J., Kinchla, N. M., Collins, J. J. Jr.
(1994). Long-term results of mitral valve reconstruction for regurgitation of the myxomatous mitral valve. J. Thorac. Cardiovasc. Surg.
107: 143-151
[Abstract][Full Text]
DeRook, F. A., Comess, K. A., Albers, G. W., Popp, R. L.
(1992). Transesophageal Echocardiography in the Evaluation of Stroke. ANN INTERN MED
117: 922-932
[Abstract]
Cott, A., McCully, J., Goldberg, W. M., Tanser, P. H., Parkinson, W.
(1992). Interdisciplinary Treatment of Morbidity in Benign Chest Pain. ANGIOLOGY
43: 195-202
[Abstract]
Lavie, C. J., Khandheria, B. K., Seward, J. B., Tajik, A. J., Taylor, C. L., Ballard, D. J.
(1989). Factors Associated With the Recommendation for Endocarditis Prophylaxis in Mitral Valve Prolapse. JAMA
262: 3308-3312
[Abstract]
Devereux, R. B., Kramer-Fox, R., Kligfield, P.
(1989). Mitral Valve Prolapse: Causes, Clinical Manifestations, and Management. ANN INTERN MED
111: 305-317
[Abstract]
Heck, A. F.
(1989). 35th Annual Meeting -- American College of Angiology Orlando, Florida -- October, 1988 Symposium Proceedings: Neurologic Aspects of Mitral Valve Prolapse. ANGIOLOGY
40: 743-751
[Abstract]
(1989). Cardiogenic Brain Embolism: The Second Report of the Cerebral Embolism Task Force. Arch Neurol
46: 727-743
[Abstract]
Cohn, L. H.
(1988). Surgery for Mitral Regurgitation. JAMA
260: 2883-2887
[Abstract]
Zimmerman, F. H., Mogtader, A. H.
(1987). Ruptured Chordae Tendineae and Acute Pulmonary Edema Induced by Exercise: Occurrence in a Young Man With Mitral Valve Prolapse. JAMA
258: 812-813
[Abstract]
Phillips, M., Robinowitz, M., Higgins, J. R., Boran, K. J., Reed, T., Virmani, R.
(1986). Sudden Cardiac Death in Air Force Recruits: A 20-Year Review. JAMA
256: 2696-2699
[Abstract]
