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Review
. 2014 May 27;129(21):2158-70.
doi: 10.1161/CIRCULATIONAHA.113.006702.

Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis

Francesca N Delling  1 , Ramachandran S Vasan  2
Affiliations
Review

Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis

Francesca N Delling et al. Circulation. .
No abstract available

Keywords: mitral valve; mitral valve insufficiency; mitral valve prolapse.

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Figures

Figure 1
Figure 1
Prolapse of the intermediate posterior mitral valve scallop (P2) shown in a long axis view of A) a 2D transthoracic echocardiogram, B) a 2D transesophageal echocardiogram (TEE) with C) associated severe, eccentric, anteriorly directed mitral regurgitation, and in a D) 3D TEE surgical view. 2D, two-dimensional; 3D, three-dimensional; AO, aorta; LV, left ventricle; and RV, right ventricle.
Figure 2
Figure 2
Cardiac magnetic resonance Steady State Free Processing (SSFP) long-axis view of bileaflet mitral valve prolapse (panel A). Short axis view with 3D late-gadolinium enhancement (LGE) showing fibrosis of the papillary muscle tips. Adapted from reference 32.
Figure 3
Figure 3
Schematic of normal mitral valve histology. ECM, extracellular matrix; GAG, glycosaminoglycans; VEC, valvular endothelial cells; VIC, valvular interstitial cells. Adapted from reference 66.
Figure 4
Figure 4
Two-dimensional parasternal long axis images of posteriorly coapting leaflets (anterior leaflet [AL]; posterior leaflet [PL]) in a normal individual A) versus increased coaptation height and an elongated posterior leaflet in an individual with ‘Abnormal Anterior Coaptation’ or AAC features B) and in a patient with bileaflet mitral valve prolapse (MVP) into the left atrium (LA) C). Schematics D) showing projections of anterior (A) and posterior (P) leaflets onto the mitral annular diameter (D). C indicates the coaptation height relative to the annulus and is calculated as P/D or C/LVID. AO, aorta; LV, left ventricle; LVID, left ventricular internal diameter; and RV, right ventricle.
Figure 5
Figure 5
Proposed temporal spectrum of mitral valve prolapse (MVP) progression with potential interventions/non-surgical therapies depending on progression stage (bottom section). MV, mitral valve; MSD, minimal systolic displacement; A, P, projections of anterior and posterior leaflets onto the mitral annulus; C; mitral leaflet coaptation height; MR, mitral regurgitation; TGF, transforming growth factor.
See this image and copyright information in PMC

References

    1. Freed LA, Levy D, Levine RA, Larson MG, Evans JC, Fuller DL, Lehman B, Benjamin EJ. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med. 1999;341:1–7. - PubMed
    1. Devereux RB, Jones EC, Roman MJ, Howard BV, Fabsitz RR, Liu JE, Palmieri V, Welty TK, Lee ET. Prevalence and correlates of mitral valve prolapse in a population-based sample of American Indians: the Strong Heart Study. Am J Med. 2001;111:679–685. - PubMed
    1. Rabkin E, Aikawa M, Stone JR, Fukumoto Y, Libby P, Schoen FJ. Activated interstitial myofibroblasts express catabolic enzymes and mediate matrix remodeling in myxomatous heart valves. Circulation. 2001;104:2525–2532. - PubMed
    1. Tamura K, Fukuda Y, Ishizaki M, Masuda Y, Yamanaka N, Ferrans VJ. Abnormalities in elastic fibers and other connective-tissue components of floppy mitral valve. Am Heart J. 1995;129:1149–1158. - PubMed
    1. Devereux RB, Kramer-Fox R, Shear MK, Kligfield P, Pini R, Savage DD. Diagnosis and classification of severity of mitral valve prolapse: methodologic, biologic, and prognostic considerations. Am Heart J. 1987;113:1265–1280. - PubMed

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