We aimed to characterize the extent and distribution of focal basal left ventricular
(LV) hypertrophy in patients with mitral valve prolapse (MVP). Sixty-three patients
(mean age: 58 ± 14 years) with MVP and 20 age-matched normal volunteers (mean age:
53 ± 11 years) were assessed using cardiac magnetic resonance imaging. We compared
the ratio of basal to mid end-diastolic wall thickness in both groups and correlated
it with clinical and imaging parameters. Of the 63 patients, 44 (70%) had posterior
leaflet prolapse, 2 (3%) had anterior leaflet prolapse, and 17 (27%) had bileaflet
prolapse. There was a significantly increased ratio of basal to mid-ventricular end-diastolic
wall thickness in all segments of the left ventricle in those with MVP compared to
the controls. The inferolateral (2.1 vs 1.0, p <0.01) and anterolateral (2.1 vs 1.1)
ratios (p <0.01) were the greatest compared to the other myocardial segments. The
degree of mitral annular excursion had a strong positive correlation with the degree
of hypertrophy (r2 = 0.81, p <0.01) and was an independent predictor in adjusted multivariate analysis
(p <0.0001). Age, body mass index, LV end-diastolic volume index, LV end -systolic
volume index, LV stroke volume index, degree of prolapse, and mitral regurgitation
volume did not have any significant correlation with the degree of hypertrophy. In
conclusion, MVP is associated with concentric basal LV hypertrophy and good correlation
between the excursion of the mitral valve annulus and the degree of relative LV hypertrophy
suggests that locally increased myocardial function could be responsible for this
remodeling.
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Article info
Publication history
Published online: February 16, 2012
Accepted:
December 19,
2011
Received in revised form:
December 19,
2011
Received:
October 30,
2011
Footnotes
Dr. Wolff is an owner of NeoSoft, LLC, Milwaukee, Wisconsin, and NeoCoil, LLC, Pewaukee, Wisconsin.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
