Key result
Classic MVP is linked to ~8-mm greater systolic papillary muscle displacement vs. normal controls.
Why the study?
Previous angiographic observations suggested that superior leaflet displacement in mitral valve prolapse causes abnormal superior tension and displacement of papillary muscle tips, potentially affecting left ventricular function, but noninvasive quantitation was needed.
Does mitral valve prolapse result in abnormal superior traction of the papillary muscles during systole compared to normal subjects?
Case-Control
Does mitral valve prolapse result in abnormal superior traction of the papillary muscles during systole compared to normal subjects?
Two-dimensional echocardiography noninvasively quantifies and confirms that mitral valve prolapse causes abnormal superior systolic traction of the papillary muscles, strongly correlating with leaflet displacement.
Supports papillary muscle traction mechanism in mitral valve prolapse; leaves open its role in fibrosis or arrhythmias.
Previous angiographic observations in patients with mitral valve prolapse have suggested that superior leaflet displacement results in abnormal superior tension on the papillary muscle tips that causes their superior traction or displacement. It has further been postulated that such tension can potentially affect the mechanical and electrophysiologic function of the left ventricle. The purpose of this study was to confirm and quantitate this phenomenon noninvasively by using two-dimensional echocardiography to determine whether superior displacement of the papillary muscle tips occurs and its relation to the degree of mitral leaflet displacement. Directed echocardiographic examination of the papillary muscles and mitral anulus was carried out in a series of patients with classic mitral valve prolapse and results were compared with those in a group of normal control subjects. Distance from the anulus to the papillary muscle tip was measured both in early and at peak ventricular systole. In normal subjects, this distance did not change significantly through systole, whereas in the patient group it decreased, corresponding to a superior displacement of the papillary muscle tips toward the anulus in systole (8.5 +/- 2.6 vs. 0.8 +/- 0.7 mm; p less than 0.0001). This superior papillary muscle motion paralleled the superior displacement of the leaflets in individual patients (y = 1.0x + 0.8; r = 0.93) and followed a similar time course.(ABSTRACT TRUNCATED AT 250 WORDS)
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Sanfilippo et al. (1992) conducted a case-control in Mitral valve prolapse. Classic mitral valve prolapse vs. Normal control subjects was evaluated on Superior displacement of the papillary muscle tips toward the anulus in systole (p=<0.0001). Patients with classic mitral valve prolapse exhibited significantly greater superior displacement of the papillary muscle tips in systole compared to normal controls (8.5 vs. 0.8 mm; p<0.0001).
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