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  Predictors of outcome of mitral valve prolapse in patients with the Marfan syndrome

Rybczynski, M., Treede, H., Sheikhzadeh, S., Groene, E. F., Bernhardt, A. M., Hillebrand, M., et al. (2011). Predictors of outcome of mitral valve prolapse in patients with the Marfan syndrome. Am J Cardiol, 107(2), 268-74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21211604 http://pdn.sciencedirect.com/science?_ob=MiamiImageURL&_cid=271073&_user=28761&_pii=S0002914910018631&_check=y&_origin=article&_zone=toolbar&_coverDate=15-Jan-2011&view=c&originContentFamily=serial&wchp=dGLzVlB-zSkWA&md5=6a650c45ade0842ed191643fd945f42c/1-s2.0-S0002914910018631-main.pdf.

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 Creators:
Rybczynski, M., Author
Treede, H., Author
Sheikhzadeh, S., Author
Groene, E. F., Author
Bernhardt, A. M., Author
Hillebrand, M., Author
Mir, T. S., Author
Kuhne, K., Author
Koschyk, D., Author
Robinson, P. N.1, Author              
Berger, J., Author
Reichenspurner, H., Author
Meinertz, T., Author
von Kodolitsch, Y., Author
Affiliations:
1Research Group Development & Disease (Head: Stefan Mundlos), Max Planck Institute for Molecular Genetics, Max Planck Society, ou_1433557              

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Free keywords: Adult; Disease Progression; Echocardiography; Female; Follow-Up Studies; Heart Ventricles/physiopathology/ultrasonography; Humans; Male; Marfan Syndrome/*complications; Mitral Valve Prolapse/*diagnosis/physiopathology; Prognosis; Retrospective Studies; Stroke Volume; Time Factors; Ventricular Function, Left
 Abstract: 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.

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Title: Am J Cardiol
Source Genre: Journal
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Affiliations:
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Pages: - Volume / Issue: 107 (2) Sequence Number: - Start / End Page: 268 - 74 Identifier: ISSN: 1879-1913 (Electronic) 0002-9149 (Linking)