RELATION BETWEEN SEVERITY OF MITRAL REGURGITATION AND PROGNOSIS OF MITRAL-VALVE PROLAPSE - ECHOCARDIOGRAPHIC FOLLOW-UP-STUDY

We investigated the relation between the severity of mitral regurgitat ion and the development of complications and cardiac events by using t wo-dimensional and color Doppler echocardiography in 229 consecutive p atients with mitral valve prolapse. The frequency of moderate and seve re mitral regurgitation was significantly higher in patients with a pr olapsed posterior leaflet (61%) than in patients with a prolapsed ante rior leaflet (25%), and the older the patient, the greater the severit y of mitral regurgitation. The occurrence of complications, such as at rial fibrillation, congestive heart failure, and chordal rupture, was significantly greater in prolapsed posterior leaflet cases than in pro lapsed anterior leaflet cases, and the occurrence was closely associat ed with the degree of severity of mitral regurgitation. Multiple logis tic regression analysis showed that the severity of mitral regurgitati on is a strong prognostic indicator for developing complications. Furt hermore, in a subgroup of 49 patients tracked for a mean of 4.8 years, the new development of complications was significantly higher in pati ents who showed a progression in the severity of mitral regurgitation (52%) than in patients without progression in severity (8%). The initi al severity of mitral regurgitation was related to the occurrence of c ardiac events (mitral valve replacement, infective endocarditis, cereb ral embolism and death). The data indicated that the progression of mi tral regurgitation Is closely associated with the development of compl ications and cardiac events and suggest that the severity of mitral re gurgitation is an important prognostic indicator for the development o f complications and cardiac events in patients with mitral valve prola pse.