Meary angle for the prediction of mitral valve prolapse risk in non-syndromic patients with pes planus, a cross-sectional study

Abstract

Objectives Mitral Valve Prolapse (MVP) is a common valvular abnormality accounting for 2% of the population. There is a reported association between pes planus (PP) and MVP in some syndromes such as Marfan. However, this association has not been tested in non-syndromic cases. The primary outcome of this study is to measure the prevalence of MVP in a population of patients with PP. The secondary outcome parameter is to determine if the Meary angle (MA), a measure of the severity of flat foot, can be effectively used in the prediction of the presence of MVP. Forty-one patients with PP were screened using a lateral x-ray foot to determine MA while echocardiography was utilized to identify the presence and grade of MVP. Results 88% of screened patients were diagnosed with MVP. MA was correlated with the grade of MVP and showed high diagnostic accuracy (sensitivity 100% and specificity 90%) in predicting MVP risk when higher than 5. Children with PP are at a higher risk for MVP than the general population. Accordingly, the utilization of MA in such a specific population for the determination of patients at a higher need for echocardiography seems to be a worthwhile strategy in diagnosing MVP.

Exploration of Flexible Pes Planus as a Potential Risk Factor for Cardiac Pathologies in Pediatric Cases

“…Additionally, it is also known that cardiac pathologies can accompany thoracic and spinal skeletal anomalies [20][21][22]. AbdelMassih et al, emphasized in their study that the risk of MVP increases with the degree of FPP [8]. In our study, it was found that the risk of cardiac pathology in patients diagnosed with FPP is higher compared to normal individuals, similar to what is observed in connective tissue diseases, and a result consistent with the literature was obtained.…”

“…As it is well-established, individuals with hypermobility syndromes may present with concomitant heart conditions, with mitral valve prolapse (MVP) being a noteworthy example [ 7 ]. In addition, it has been demonstrated that as the degree of FPP increases, the risk of concomitant MVP also increases [ 8 ]. Furthermore, in connective tissue disorders characterized by hypermobility such as Marfan syndrome and Ehler-Danlos syndrome, cardiac pathologies can also be encountered [ 9 , 10 ].…”