Mitral valve prolapse and coronary artery disease. Clinical, hemodynamic, and angiographic correlations.

Aranda, Juan M.; Befeler, Benjamin; Lazzara, Ralph; Embí, Abrahám A.; Machado, Humberto

doi:10.1161/01.cir.52.2.245

Cited by 63 publications

(10 citation statements)

References 39 publications

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“…Verani et al [34] and Raizada et al [29] have also reported a high incidence of prolapse of the mitral valve among patients with coronary artery disease. Papillary muscle dys function, secondary to coronary artery disease, has been reported to pro duce prolapse of the mitral valve [2,6,17,33]. In the series of Verani et al [34], as in ours, some patients were not suspected of having pro lapse of the mitral valve prior to cardiac catheterization.…”

Section: Association Of Coronary Artery Disease and Mitral Valve Prolsupporting

confidence: 47%

“…Significant coronary artery disease was considered to be present when one or more of the major coronary arteries had 70% or more narrowing of the diameter of the vessel in one dimension. Viewed from different projections prolapse of the mitral valve was judged to be present when there was definite abnormal systolic bulge of one or both leaflets into the left atrium [2,[29][30][31], Posterior mitral valve leaflet prolapse produced most commonly three well-defined scallops [15,22,29,30], Oc casionally, only one or two scallops were seen in the RAO projection [29, 30J. Anterior mitral valve leaflet prolapse was seen as a hump on the anterior surface of the ventricle just beneath the aortic root [15], or as a double density overlapping one or more of the scallops of the posterior leaflet [30], In the LAO projection, the prolapse of the anterior leaflet produced abnormal bulge with its fullicrum attached to the aortic root. Arbitrarily, the degree of mitral valve prolapse was classified into three grades of severity: mild, moderate and severe ( fig.…”

Section: Methodsmentioning

confidence: 99%

“…Several recent studies have provided detailed information regarding the morphologic [1,3,9,15,20], pathophysiologic [14,15,23,26], clin ical [2,7,13,15,30], hemodynamic [2,20], echocardiographic [8,10,11,27,29,35], angiographic [2,5,12,20,30,32], and epidemiologic [4,21,28] aspects of prolapsed mitral valve.…”

Section: Introductionmentioning

confidence: 99%

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Prolapse of the Mitral Valve: Clinical, Hemodynamic, Angiographic and Echocardiographic Correlations

Iskandrian¹,

Kotler²,

Kimbiris³

et al. 1978

Cardiology

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Among 1,519 patients undergoing diagnostic cardiac catheterization over a 2-year period, angiographically unequivocal mitral valve prolapse was identified in 79 cases (5.2%). Mitral valve prolapse was clinically unsuspected in 30 of these 79 patients. Echocardiographic studies were available in 44 cases, but only 55% of the patients with prolapse of the mitral valve documented by angiography had positive echocardiographic findings. One third of the patients had associated coronary artery disease, aortic valve disease or atrial septal defects. 14 patients (18%) had moderate or severe mitral regurgitation. There was a wide spectrum of hemodynamic and ventriculographic abnormalities that could not entirely be explained by the degree of prolapse, by the severity of mitral regurgitation or by the presence of associated diseases.

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Section: Association Of Coronary Artery Disease and Mitral Valve Prolsupporting

confidence: 47%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Prolapse of the Mitral Valve: Clinical, Hemodynamic, Angiographic and Echocardiographic Correlations

Iskandrian¹,

Kotler²,

Kimbiris³

et al. 1978

Cardiology

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“…13 ' M Systemic hemodynamic findings in patients with mitral valve prolapse have been reported to be normal unless a significant degree of mitral regurgitation is present. 12 …”

mentioning

confidence: 99%

Mitral valve prolapse and borderline hypertension.

deCarvalho¹,

Messerli²,

Fröhlich³

1979

Hypertension

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SUMMARY Systemic hemodynamics, plasma volume and circulating catecholamlne levels were measured under baseline conditions in 21 patients with idiopathic mitral valve prolapse (IMVP), 13 with and eight without borderline hypertension, and compared with two control populations comprised of 34 normotensive and 15 borderline hypertensive subjects without mitral valve prolapse. The IMVP population had a faster heart rate (73 ± 2 vs 67 ± 2 beats/minute; p < 0.05) and a greater cardiac index (3.5 ± 0.1 vs 3.0 ± 0.1 liters/min/m 1 ;/? < 0.025) than the normotensive controls. However, heart rate and cardiac index were similar in IMVP and borderline hypertensive patients. The IMVP patients showed an increased responsiveness of heart rate and systolic arterial pressure during beta-adrenergic receptor stimulation (isoproteretiol infusion) when compared to the second control group of patients with borderline hypertension who had similar hyperdynamic circulation. Responses to upright tilt, Valsalva maneuver, and handgrip, however, did not differ between the IMVP and the two control groups. Circulating catecbolamine levels were slightly higher in IMVP patients. It is concluded that some IMVP patients (with or without hypertension) demonstrate increased betaadrenergic receptor responsiveness associated with a hyperkinetic circulation. Therefore, a hyperbeta-

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“…The association of mitral valve prolapse with obstructive coronary disease is recognised yet controversial (Davis et al, 1971;Steelman et al, 1971;Cheng, 1972;Gooch et al, 1972;Liedtke et al, 1973;Scampardonis et al, 1973;Jeresaty, 1973Jeresaty, , 1975Aranda et al, 1975;Gentzler et al, 1975). Some investigators (Cheng, 1972) maintain that coronary artery disease can produce mitral ballooning by virtue of papillary muscle ischaemia or fibrosis.…”

mentioning

confidence: 99%

Mitral valve prolapse in patients with coronary artery disease. Echocardiographic-angiographic correlation.

Raizada¹,

Benchimol²,

Desser³

et al. 1977

Heart

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Echocardiography was performed in 25 consecutive patients with angina pectoris and angiographically demonstrable coronary artery disease. Left ventricular echograms detected late or pansystolic mitral valve bowing suggesting of mitral valve proplapse in 6/25 (24%). Left ventricular angiography showed prolapse of the posterior mitral leaflet in 15/25 (60%), including 5 detected by echocardiography. Significant triple vessel coronary disease was present in 11 of 15 patients with prolapsed mitralvalve. In each of the latter a greater than 90 per cent obstructive lesion was noted in at least one coronary artery: right coronary artery, 9 subjects (82%); left circumflex coronary artery, 5 patients (33%); and left anterior descending coronary artery, 4 patients (27%). Of 15 subjects with angiographic evidence of mitral valve prolapse, 13 had left ventricular asynergy-inferior or inferoposterior in 8 subjects (62%) and anterior or anteroapical in 5 subjects (38%). Eleven subjects had vectorcardiographic evidence of transmural myocardial infarction-inferior or inferoposterior in 9 (82%) and anteroseptal in 2 (18%). A single subject with mitral valve prolapse had mild mitral regurgitation. It is concluded that: (1) coexisting prolapse of the posterior mitral valve leaflet and coronary artery disease is usually associated with triple vessel obstructive lesions, (2) severe right coronary disease, inferior left ventricular wall asynergy, and inferior myocardial infarction are important angiographic and vectorcardiographic correlates, and (3) echocardiography will detect such mitral valve prolapse in only one-third of affected cases.

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Mitral valve prolapse and coronary artery disease. Clinical, hemodynamic, and angiographic correlations.

Abstract: SUMMARYAmong 95 patients with angina pectoris and angiographically documented coronary artery disease (CAD), prolapse of the scallops of the posterior leaflet of the mitral valve (PLMV)

Cited by 63 publications

References 39 publications

Prolapse of the Mitral Valve: Clinical, Hemodynamic, Angiographic and Echocardiographic Correlations

Prolapse of the Mitral Valve: Clinical, Hemodynamic, Angiographic and Echocardiographic Correlations

Mitral valve prolapse and borderline hypertension.

Mitral valve prolapse in patients with coronary artery disease. Echocardiographic-angiographic correlation.

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