We investigated the significance of mitral valve prolapse (MVP) and au
tonomic function in 121 patients diagnosed with panic disorder (PD). T
he incidence of MVP was higher in these patients (32.2%) than in the h
ealthy controls (16.7%), but the difference was not significant. In th
e group with PD accompanied by depression, the MVP rate was 58.1%, sig
nificantly higher than the value of 25.7% observed in the PD patients
without depression. The severity of MW was mild; nearly all of the cas
es were silent, without cardiac murmur, and there was no problem with
the left ventricular function. The coefficient of variation for R-R in
tervals on electrocardiograms (CV R-R) was smaller in patients with PD
than in healthy controls. The CV R-R of PD patients was significantly
lower in the group with MVP than in the group without MVP, suggesting
a strong association with the parasympathetic nervous system. Since t
he CV R-R tended to decrease in the presence of depression, involvemen
t of the parasympathetic nervous system was inferred.