Predictors of outcome of mitral valve prolapse in patients with the Marfan syndrome
Standard
Predictors of outcome of mitral valve prolapse in patients with the Marfan syndrome. / Rybczynski, Meike; Treede, Hendrik; Sheikhzadeh, Sara; Groene, Eike F; Bernhardt, Alexander M J; Hillebrand, Mathias; Mir, Thomas S; Kühne, Kristine; Koschyk, Dietmar; Robinson, Peter N; Berger, Jürgen; Reichenspurner, Hermann; Meinertz, Thomas; von Kodolitsch, Yskert.
in: AM J CARDIOL, Jahrgang 107, Nr. 2, 15.01.2011, S. 268-274.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Predictors of outcome of mitral valve prolapse in patients with the Marfan syndrome
AU - Rybczynski, Meike
AU - Treede, Hendrik
AU - Sheikhzadeh, Sara
AU - Groene, Eike F
AU - Bernhardt, Alexander M J
AU - Hillebrand, Mathias
AU - Mir, Thomas S
AU - Kühne, Kristine
AU - Koschyk, Dietmar
AU - Robinson, Peter N
AU - Berger, Jürgen
AU - Reichenspurner, Hermann
AU - Meinertz, Thomas
AU - von Kodolitsch, Yskert
N1 - Copyright © 2011 Elsevier Inc. All rights reserved.
PY - 2011/1/15
Y1 - 2011/1/15
N2 - Mitral valve prolapse has a prevalence of 2% to 3% in the general population, with adverse outcomes such as mitral valve regurgitation (MVR), heart failure, and endocarditis. Predictors of outcomes are used in idiopathic mitral valve prolapse for the timing of surgery, but such predictors are unknown in Marfan syndrome. Therefore, a population-based cohort study of 112 patients (49 male, 63 female; mean age 34 ± 15 years) with classic Marfan syndrome and mitral valve prolapse with moderate or less MVR at baseline was conducted. During 4.6 ± 3.6 years of follow-up, progression of MVR was observed in 41 patients and valve-related events, which comprised mitral valve endocarditis (7 events), heart failure (5 events), and mitral valve surgery (25 events), were observed in 31 patients. Multivariate Cox proportional-hazards regression analysis identified a flail mitral leaflet (hazard ratio [HR] 3.262, 95% confidence interval [CI] 1.406 to 7.566, p = 0.006) and increased indexed end-systolic left ventricular diameters (HR 1.113, 95% CI 1.043 to 1.188, p = 0.001) as independent predictors of progression of MVR. Similarly, mitral valve-related events were independently predicted by a flail mitral leaflet (HR 5.343, 95% CI 2.229 to 12.808, p <0.001), and mild (HR 14.336, 95% CI 1.873 to 109.755, p = 0.01) or moderate (HR 16.849, 95% CI 2.205 to 128.76, p = 0.006) degree of MVR. Conversely, aortic dilatation, dural ectasia, and sporadic mode of inheritance were not associated with outcome. In conclusion, the same clinical determinants that predict outcomes in idiopathic mitral valve prolapse also predict outcomes in mitral valve prolapse associated with Marfan syndrome.
AB - Mitral valve prolapse has a prevalence of 2% to 3% in the general population, with adverse outcomes such as mitral valve regurgitation (MVR), heart failure, and endocarditis. Predictors of outcomes are used in idiopathic mitral valve prolapse for the timing of surgery, but such predictors are unknown in Marfan syndrome. Therefore, a population-based cohort study of 112 patients (49 male, 63 female; mean age 34 ± 15 years) with classic Marfan syndrome and mitral valve prolapse with moderate or less MVR at baseline was conducted. During 4.6 ± 3.6 years of follow-up, progression of MVR was observed in 41 patients and valve-related events, which comprised mitral valve endocarditis (7 events), heart failure (5 events), and mitral valve surgery (25 events), were observed in 31 patients. Multivariate Cox proportional-hazards regression analysis identified a flail mitral leaflet (hazard ratio [HR] 3.262, 95% confidence interval [CI] 1.406 to 7.566, p = 0.006) and increased indexed end-systolic left ventricular diameters (HR 1.113, 95% CI 1.043 to 1.188, p = 0.001) as independent predictors of progression of MVR. Similarly, mitral valve-related events were independently predicted by a flail mitral leaflet (HR 5.343, 95% CI 2.229 to 12.808, p <0.001), and mild (HR 14.336, 95% CI 1.873 to 109.755, p = 0.01) or moderate (HR 16.849, 95% CI 2.205 to 128.76, p = 0.006) degree of MVR. Conversely, aortic dilatation, dural ectasia, and sporadic mode of inheritance were not associated with outcome. In conclusion, the same clinical determinants that predict outcomes in idiopathic mitral valve prolapse also predict outcomes in mitral valve prolapse associated with Marfan syndrome.
KW - Adult
KW - Disease Progression
KW - Echocardiography
KW - Female
KW - Follow-Up Studies
KW - Heart Ventricles/diagnostic imaging
KW - Humans
KW - Male
KW - Marfan Syndrome/complications
KW - Mitral Valve Prolapse/diagnosis
KW - Prognosis
KW - Retrospective Studies
KW - Stroke Volume
KW - Time Factors
KW - Ventricular Function, Left
U2 - 10.1016/j.amjcard.2010.08.070
DO - 10.1016/j.amjcard.2010.08.070
M3 - SCORING: Journal article
C2 - 21211604
VL - 107
SP - 268
EP - 274
JO - AM J CARDIOL
JF - AM J CARDIOL
SN - 0002-9149
IS - 2
ER -