975-76 Mitral Valve Structural Abnormalities In Mitral Valve Prolapse

The floppy mitral valve is the underlying pathology in mitral valve prolapse (MVP). However, posterior displacement of the mitral valve (MV) has been used for the echocardiographic diagnosis of MVP and not the structural abnormalities characteristic of the floppy mitral valve IFMV) resulting in MVP Since the current diagnostic criteria are limited by the influence of hemodynamic and neurohormonal factors on the degree of MVP, the structure of the MV which has Important prognostic implications should be used for the diagnosis of FMV-MVP Thus, 68 normal subjects (mean age = 40 years, range 18–76) were compared with 55 patients with MVP (mean age = 37 years, range 18–83). Leaflet displacement across the annular plane in the parasternal long-axis view (PLA) was mandatory for the diagnosis of MVP Transthoracic echocardiographic measurements of marginal leaflet thickness, leaflet length and chordal length were made of the anterior leaflet from the parasternal long-axis view and mitral annular diameter from the apical 4-chamber view. Values 2SD above the normal mean were considered abnormal (%ABN). Results Normal %ABN MVP %ABN marginal thickness (mm) 4.07 ± 044 3 5.32 ± 0.75 * 59 annular diameter (mm) 26.9 ± 1.5 3 31.1 ± 2.3 * 31 leaflet length (mm) 22.8 ± 2.0 1 25.7 ± 1.7 ** 26 chordal length (mm) 25.6 ± 2.7 3 26.0 ± 2.5 ** 7 * p 0.0001 vs normal ** p l 0.05 vs normal Among MVP patients over 70% had at least one and 40% had at least two structural abnormalities. In addition, MVP patients with significant mitral regurgitation had increased leaflet thickness (p l 0.01) and annular diameter (p ∼ 0.0001) compared to patients without significant MR. Conclusions The majority of MVP patients have structural abnormalities which can be defined echocardiographically. Structural abnormalities are rarely seen in normal subjects. The assessment of leaflet thickness, annular diameter, leaflet length and chordal length is fundamental to the definition and stratification of patients with FMV