Individuals with mitral valve prolapse (MVP) have exercise intolerance even without mitral valve regurgitation. Mitral valve degeneration may progress with aging. We aimed to evaluate the influence of MVP on the cardiopulmonary function (CPF) of individuals with MVP through serial follow-ups from early to late adolescence. Thirty patients with MVP receiving at least two cardiopulmonary exercise tests (CPETs) using a treadmill (MVP group) were retrospectively analyzed. Age-, sex-, and body mass index-matched healthy peers, who also had serial CPETs, were recruited as the control group. The average time from the first CPET to the last CPET was 4.28 and 4.06 years in the MVP and control groups, respectively. At the first CPET, the MVP group had a significantly lower peak rate pressure product (PRPP) than the control group (p = 0.022). At the final CEPT, the MVP group had lower peak metabolic equivalent (MET, p = 0.032) and PRPP (p = 0.031). Moreover, the MVP group had lower peak MET and PRPP as they aged, whereas healthy peers had higher peak MET (p = 0.034) and PRPP (p = 0.047) as they aged. Individuals with MVP had poorer CPF than healthy individuals as they develop from early to late adolescence. It is important for individuals with MVP to receive regular CPET follow-ups.

Purpose: Complex decongestive treatment (CDT) and extracorporeal shockwave therapy (ESWT) have been shown to be effective in the treatment of early-stage breast-cancer-related lymphedema (BCRL) but less so for later-stage. This study examined the effects of ESWT on late-stage BCRL (Stages IIb and III) as an adjunct treatment after prolonged CDT failed. Patients and Methods: 11 female patients with BCRL who had undergone at least 6 months of CDT monotherapy without measurable effects received ESWT 3 times a week for 12 weeks with concurrent CDT. Limb circumference and the thicknesses of the skin, subcutaneous tissue, and muscle layers were measured using a measuring tape and ultrasound, respectively, in the most edematous regions of both the forearm and upper arm. Results: After the addition of ESWT to CDT, the mean circumference, thickness of the skin layer, and the thickness of the subcutaneous tissue layer of the affected limb decreased significantly (p < 0.05), while the mean thickness of muscle on the affected limb increased slightly but not significantly (forearm, p = 0.348; upper arm, p = 0.100). On the unaffected limb, no significant changes were measured (p > 0.05). Conclusions: ESWT as an adjunct treatment to CDT monotherapy after a period of 6 months showed significant reductions in distal and proximal upper limb circumference, skin layer thickness, and subcutaneous tissue layer thickness in patients suffering from prolonged late stage (IIb and III) BCRL, suggesting that the combination therapy was effective on severe BCRL and fibrotic lesions that could not be effectively treated by CDT alone.

Patients with mitral valve prolapse (MVP) have been reported to have exercise intolerance. However, the underlying pathophysiological mechanisms and their physical fitness remain unclear. We aimed to determine the exercise capacity of patients with MVP through the cardiopulmonary exercise test (CPET). We retrospectively collected the data of 45 patients with a diagnosis of MVP. Their CPET and echocardiogram results were compared with 76 healthy individuals as primary outcomes. No significant differences regarding the patient’s baseline characteristics and echocardiographic data were found between the two groups, except for the lower body mass index (BMI) of the MVP group. Patients in the MVP group demonstrated a similar peak metabolic equivalent (MET), but a significantly lower peak rate pressure product (PRPP) (p = 0.048). Patients with MVP possessed similar exercise capacity to healthy individuals. The reduced PRPP may indicate compromised coronary perfusion and subtle left ventricular function impairment.