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Abstract
Background
Mitral valve prolapse(MVP) is now recognized as one of the most common cardiovascular disorders, particularly in young women with a slender body habitus. However, there is little clinical information about young men with mitral valve prolapse. The purpose of this study was to evaluate the physical and echocardiographic characteristics of young men about 20 years old with mitral valve prolapse.
Method
Twenty young men with mitral valve prolapse(MVP group, mean age; 19.9 ± 2.4 years) and twenty healthy volunteers(control group, mean age; 19.9 ± 3.2 years) were examined using physical examination, chest X-ray, computed thoracic tomography and two dimensional and Doppler echocardiography.
Results
Compared with control group, MVP group had a smaller chest circumference(p < 0.001), a larger height-arm span difference(p < 0.01), smaller anteroposterior chest diameters (by chest X-ray; p < 0.001 and computed tomography; p < 0.01) and smaller anteroposterior/transverse chest diameter ratio(chest X-ray; p < 0.01 and computed tomography; p < 0.05). In MVP group, mitral regurgitation was noted 15 men(75%), those had posteriorly directed jets suggesting anterior mitral leaflet anomalies.
References
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Fig. 1.
Left, Computed thoracic tomography of a patient with pectus excavatum: transverse diameter measuring the inner borders of the right and left ribs at the level of the eighth thoracic vertebra, and anteroposterior diameter measuring the inner borders of the anterior and posterior ribs at the level of the eighth thoracic vertebra. Right, Posteroanterior and lateral chest X-ray films of a patient with straight back: transverse diameter measuring the inner borders of the right and left ribs at the level of the dome of diaphragm, and anteroposterior diameter measuring the inner borders of the anterior and posterior ribs at the level of the eighth thoracic vertebra.
Fig. 2.
Transthoracic(left) and transesophageal echocardiogram(right) show systolic doming(arrow) of the anterior mitral valve into the left atrium.
Fig. 3.
Parasternal long axis echocardiograms showing systolic prolapse of the anterior mitral valve(arrow, right) and M-mode echocardiograms of the same patient showing holosystolic prolapse of the anterior mitral valve(two arrows, left).
Fig. 4.
Parasternal long axis views show redundancy and billowing of anterior leaflet of mitral valve(left) and posteriorly directed turbulent jet from anterior leaflet of mitral valve(right).
Fig. 5.
Parasternal long axis view(left) shows posteriorly directed turbulent jet from anterior leaflet, and parasternal short axis view(right) shows that jet originated from lateral portion of anterior leaflet.
Fig. 6.
Modified parasternal long axis views show redundancy of anterior leaflet of mitral valve(left, arrows) and two posteriorly directed jets from anterior leaflet of mitral valve(right).
Table 1.
Echocardiographic findings of young men with mitral valve prolapse
| M형 심초음파도 소건 | |
| 범수축기성 후방운농 | 20 례 |
| 수축중기 또는 후기후방 | 0 례 |
| 숭모판역류증( ) | 5 례 |
| 숭모판역류중(+) | 15 례 |
| 전엽내측 후엽 | 6 례 |
| ·!엽중앙-후엽 | 2 례 |
| 선엽외측-후엽 | 5 례 |
| 선엽내측과 외측 후·엮 | 2 에 |
Table 2.
General physical examinations in young men with MVP and healthy volunteers
Table 3.
Chest X-ray and computed tomography findings in young men with MVP and healthy volunteers
| 숭R판인탈증 | 건강대조군 | P value | |
|---|---|---|---|
| Chest X-ray(N = 40) | |||
| Transverse diameter(cm)∗ | 28.4 ± 1.9 | 29.3 ± 1.1 | NS |
| AP diameter(cm)∗∗ | 19.6 ± 1.8 | 21.6 ± 1.2 | < 0.001 |
| AP/Transverse ratio | 0.69 ± 0.05 | 0.73 ± 0.04 | <0.01 |
| Chest CT(N = 20) | |||
| Transverse diameter(cm)+ | 25.9 ± 9.6 | 26.5 ± 14.3 | NS |
| AP diameter(cm)++ | 14.8 ± 1.2 | 16.0 ± 0.9 | <0.01 |
| AP/Transverse ratio | 0.57 ± 0.04 | 0.60 ± 0.02 | <0.05 |
∗ Transverse diameter measuring the inner borders of the right and left ribs at the level of the dome of diaphragm.
∗∗ Anteroposterior diameter measuring the inner borders of the anterior and posterior ribs at the level of the eighth thoracic vertebra.
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