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Risk, Determinants, and Outcome Implications of Progression of Mitral Regurgitation After Diagnosis of Mitral Valve Prolapse in a Single Community

To analyze the evolution of mitral regurgitation (MR) after the diagnosis of mitral valve prolapse in community patients, 285 residents of Olmsted County, Minnesota, diagnosed with mitral valve prolapse without severe MR were studied. MR grade was assessed at diagnosis and at follow-up 1,663 ± 1,079... Full description

Journal Title: The American journal of cardiology 2008, Vol.101 (5), p.662-667
Main Author: Avierinos, Jean-Francois, MD
Other Authors: Detaint, Delphine, MD , Messika-Zeitoun, David, MD , Mohty, Dania, MD , Enriquez-Sarano, Maurice, MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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title: Risk, Determinants, and Outcome Implications of Progression of Mitral Regurgitation After Diagnosis of Mitral Valve Prolapse in a Single Community
format: Article
creator:
  • Avierinos, Jean-Francois, MD
  • Detaint, Delphine, MD
  • Messika-Zeitoun, David, MD
  • Mohty, Dania, MD
  • Enriquez-Sarano, Maurice, MD
subjects:
  • Abridged Index Medicus
  • Age Factors
  • Biological and medical sciences
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Cardiovascular disease
  • Clinical outcomes
  • Disease Progression
  • Echocardiography, Doppler
  • Endocardial and cardiac valvular diseases
  • Female
  • Follow-Up Studies
  • Heart
  • Heart Atria - diagnostic imaging
  • Heart Atria - physiopathology
  • Humans
  • Male
  • Medical sciences
  • Middle Aged
  • Mitral valve insufficiency
  • Mitral Valve Insufficiency - diagnostic imaging
  • Mitral Valve Insufficiency - physiopathology
  • Mitral valve prolapse
  • Mitral Valve Prolapse - diagnosis
  • Mitral Valve Prolapse - physiopathology
  • Multivariate Analysis
  • Severity of Illness Index
  • Ultrasonic imaging
  • Ventricular Dysfunction, Left - diagnostic imaging
  • Ventricular Dysfunction, Left - physiopathology
  • Ventricular Remodeling - physiology
ispartof: The American journal of cardiology, 2008, Vol.101 (5), p.662-667
description: To analyze the evolution of mitral regurgitation (MR) after the diagnosis of mitral valve prolapse in community patients, 285 residents of Olmsted County, Minnesota, diagnosed with mitral valve prolapse without severe MR were studied. MR grade was assessed at diagnosis and at follow-up 1,663 ± 1,079 days later using Doppler echocardiography. The progression of MR was defined as an increase of ≥1 MR grade. The patients’ mean age was 56 ± 22 years, 57% were women, and the mean ejection fraction was 60 ± 9%. Between diagnostic and follow-up echocardiography, 108 patients showed progression of MR, 39 of whom had progression ≥1 grade. The mean overall MR grade increased from 0.4 ± 0.7 to 0.9 ± 1.1 (p
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleRisk, Determinants, and Outcome Implications of Progression of Mitral Regurgitation After Diagnosis of Mitral Valve Prolapse in a Single Community
creatorAvierinos, Jean-Francois, MD ; Detaint, Delphine, MD ; Messika-Zeitoun, David, MD ; Mohty, Dania, MD ; Enriquez-Sarano, Maurice, MD
creatorcontribAvierinos, Jean-Francois, MD ; Detaint, Delphine, MD ; Messika-Zeitoun, David, MD ; Mohty, Dania, MD ; Enriquez-Sarano, Maurice, MD
descriptionTo analyze the evolution of mitral regurgitation (MR) after the diagnosis of mitral valve prolapse in community patients, 285 residents of Olmsted County, Minnesota, diagnosed with mitral valve prolapse without severe MR were studied. MR grade was assessed at diagnosis and at follow-up 1,663 ± 1,079 days later using Doppler echocardiography. The progression of MR was defined as an increase of ≥1 MR grade. The patients’ mean age was 56 ± 22 years, 57% were women, and the mean ejection fraction was 60 ± 9%. Between diagnostic and follow-up echocardiography, 108 patients showed progression of MR, 39 of whom had progression ≥1 grade. The mean overall MR grade increased from 0.4 ± 0.7 to 0.9 ± 1.1 (p <0.01). The progression of MR was observed in all subsets, irrespective of age, gender, prolapse localization, leaflet thickening, and initial MR grade. However, multivariate analysis identified age (p <0.01) and initial MR grade (p = 0.01) as independent predictors of progression. In addition, MR progression was associated with greater left atrial enlargement (p <0.001), ventricular dilatation (p = 0.02 for increase in end-diastolic and end-systolic diameters), and a worse outcome (adjusted p = 0.001). In conclusion, in patients with mitral valve prolapse, MR progression was observed over time in all clinical and anatomic subsets and was associated with more severe ventricular and atrial remodeling and worse outcome.
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subjectAbridged Index Medicus ; Age Factors ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Clinical outcomes ; Disease Progression ; Echocardiography, Doppler ; Endocardial and cardiac valvular diseases ; Female ; Follow-Up Studies ; Heart ; Heart Atria - diagnostic imaging ; Heart Atria - physiopathology ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral valve insufficiency ; Mitral Valve Insufficiency - diagnostic imaging ; Mitral Valve Insufficiency - physiopathology ; Mitral valve prolapse ; Mitral Valve Prolapse - diagnosis ; Mitral Valve Prolapse - physiopathology ; Multivariate Analysis ; Severity of Illness Index ; Ultrasonic imaging ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Remodeling - physiology
ispartofThe American journal of cardiology, 2008, Vol.101 (5), p.662-667
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descriptionTo analyze the evolution of mitral regurgitation (MR) after the diagnosis of mitral valve prolapse in community patients, 285 residents of Olmsted County, Minnesota, diagnosed with mitral valve prolapse without severe MR were studied. MR grade was assessed at diagnosis and at follow-up 1,663 ± 1,079 days later using Doppler echocardiography. The progression of MR was defined as an increase of ≥1 MR grade. The patients’ mean age was 56 ± 22 years, 57% were women, and the mean ejection fraction was 60 ± 9%. Between diagnostic and follow-up echocardiography, 108 patients showed progression of MR, 39 of whom had progression ≥1 grade. The mean overall MR grade increased from 0.4 ± 0.7 to 0.9 ± 1.1 (p <0.01). The progression of MR was observed in all subsets, irrespective of age, gender, prolapse localization, leaflet thickening, and initial MR grade. However, multivariate analysis identified age (p <0.01) and initial MR grade (p = 0.01) as independent predictors of progression. In addition, MR progression was associated with greater left atrial enlargement (p <0.001), ventricular dilatation (p = 0.02 for increase in end-diastolic and end-systolic diameters), and a worse outcome (adjusted p = 0.001). In conclusion, in patients with mitral valve prolapse, MR progression was observed over time in all clinical and anatomic subsets and was associated with more severe ventricular and atrial remodeling and worse outcome.
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1Age Factors
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3Cardiology
4Cardiology. Vascular system
5Cardiovascular
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7Clinical outcomes
8Disease Progression
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12Follow-Up Studies
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15Heart Atria - physiopathology
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22Mitral Valve Insufficiency - physiopathology
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25Mitral Valve Prolapse - physiopathology
26Multivariate Analysis
27Severity of Illness Index
28Ultrasonic imaging
29Ventricular Dysfunction, Left - diagnostic imaging
30Ventricular Dysfunction, Left - physiopathology
31Ventricular Remodeling - physiology
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titleRisk, Determinants, and Outcome Implications of Progression of Mitral Regurgitation After Diagnosis of Mitral Valve Prolapse in a Single Community
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9Echocardiography, Doppler
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abstractTo analyze the evolution of mitral regurgitation (MR) after the diagnosis of mitral valve prolapse in community patients, 285 residents of Olmsted County, Minnesota, diagnosed with mitral valve prolapse without severe MR were studied. MR grade was assessed at diagnosis and at follow-up 1,663 ± 1,079 days later using Doppler echocardiography. The progression of MR was defined as an increase of ≥1 MR grade. The patients’ mean age was 56 ± 22 years, 57% were women, and the mean ejection fraction was 60 ± 9%. Between diagnostic and follow-up echocardiography, 108 patients showed progression of MR, 39 of whom had progression ≥1 grade. The mean overall MR grade increased from 0.4 ± 0.7 to 0.9 ± 1.1 (p <0.01). The progression of MR was observed in all subsets, irrespective of age, gender, prolapse localization, leaflet thickening, and initial MR grade. However, multivariate analysis identified age (p <0.01) and initial MR grade (p = 0.01) as independent predictors of progression. In addition, MR progression was associated with greater left atrial enlargement (p <0.001), ventricular dilatation (p = 0.02 for increase in end-diastolic and end-systolic diameters), and a worse outcome (adjusted p = 0.001). In conclusion, in patients with mitral valve prolapse, MR progression was observed over time in all clinical and anatomic subsets and was associated with more severe ventricular and atrial remodeling and worse outcome.
copNew York, NY
pubElsevier Inc
pmid18308017
doi10.1016/j.amjcard.2007.10.029