Prognosis

• in patients with asymptomatic mitral valve prolapse, a study has revealed that mortality and cardiovascular morbidity increased over time (1)
• this study provides data to allow clearer risk statification of asymptomatic patients with newly diagnosed mitral valve prolapse
  • if a patient had either one of the two primary risk factors (an ejection fraction of < 50% or at least moderate mitral regurgitation) then s/he was considered at high risk - if compared with other groups over 10 years then patients at high risk had a greater cardiovascular morbidity and mortality, with a 45% mortality rate
  • intermediate risk was defined by the presence of >=2 secondary risk factors (slight mitral regurgitation, atrial fibrillation, flail leaflet, left atrium >= 40 mm, age >= 50 years) - these patients had a 10 year survival similar to that expected but a 40% cardiovascular morbidity
  • if a patient had zero or 1 secondary risk factor then s/he had a similar outcome to that of the general population
  • this study revealed a community population where 52% were low risk, 30% were intermediate risk, and 18% were high risk at diagnosis

Reference:

1. Avierinos J-F et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation 2002;106:1355-61