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Volume 341:1-7 July 1, 1999 Number 1 Next

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ABSTRACT

Background Mitral-valve prolapse has been described as a common disease with frequent complications. To determine the prevalence of mitral-valve prolapse in the general population, as diagnosed with the use of current two-dimensional echocardiographic criteria, we examined the echocardiograms of 1845 women and 1646 men (mean [±SD] age, 54.7±10.0 years) who participated in the fifth examination of the offspring cohort of the Framingham Heart Study.

Methods Classic mitral-valve prolapse was defined as superior displacement of the mitral leaflets of more than 2 mm during systole and as a maximal leaflet thickness of at least 5 mm during diastasis, and nonclassic prolapse was defined as displacement of more than 2 mm, with a maximal thickness of less than 5 mm.

Results A total of 84 subjects (2.4 percent) had mitral-valve prolapse: 47 (1.3 percent) had classic prolapse, and 37 (1.1 percent) had nonclassic prolapse. Their age and sex distributions were similar to those of the subjects without prolapse. None of the subjects with prolapse had a history of heart failure, one (1.2 percent) had atrial fibrillation, one (1.2 percent) had cerebrovascular disease, and three (3.6 percent) had syncope, as compared with unadjusted prevalences of these findings in the subjects without prolapse of 0.7, 1.7, 1.5, and 3.0 percent, respectively. The frequencies of chest pain, dyspnea, and electrocardiographic abnormalities were similar among subjects with prolapse and those without prolapse. The subjects with prolapse were leaner (P<0.001) and had a greater degree of mitral regurgitation than those without prolapse, but on average the regurgitation was classified as trace or mild.

Conclusions In a community-based sample of the population, the prevalence of mitral-valve prolapse was lower than previously reported. The prevalence of adverse sequelae commonly associated with mitral-valve prolapse in studies of patients referred for that diagnosis was also low.

Source Information

From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass. (L.A.F., D.L., M.G.L., J.C.E., D.L.F., B.L., E.J.B.); the Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston (L.A.F., R.A.L.); Harvard Medical School, Boston (L.A.F., D.L., R.A.L.); the National Heart, Lung, and Blood Institute, Bethesda, Md. (D.L.); the Divisions of Cardiology and Clinical Epidemiology, Beth Israel Deaconess Medical Center, Boston (D.L.); and the Divisions of Cardiology (D.L., E.J.B.) and Epidemiology and Preventive Medicine (D.L., M.G.L., J.C.E., E.J.B.), Boston University School of Medicine, Boston.

Address reprint requests to Dr. Benjamin at the Framingham Heart Study, Boston University School of Medicine, 5 Thurber St., Framingham, MA 01702-6334, or at emelia{at}fram.nhlbi. nih.gov.

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Mitral-Valve Prolapse
Jeresaty R. M., Cheng T. O., Freed L. A., Levy D., Levine R. A., Evans J. C., Benjamin E. J.
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N Engl J Med 1999; 341:1471-1472, Nov 4, 1999. Correspondence

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