Abstract

SATUT, ZARAYA et al. Evolución clínica de los pacientes con prolapso valvular mitral. Rev.Urug.Cardiol. [online]. 2006, vol.21, n.3, pp.195-203. ISSN 1688-0420.

SUMMARY Mitral valve prolapse (MVP) is a frequent echocardiographic diagnosis. The clinical evolution of patients with MVP is very variable. There are no national data about the clinical evolution of these patients. The aim of this report is to study the clinical evolution of patients with an echocardiographic diagnosis of MVP and to detect risk factors of a bad evolution. Methods: the clinical evolution of a historical cohort of 873 patients with diagnosis of MVP was studied through a telephonic interview using a structured questionnaire. Rates of cardiovascular events and cardiovascular deaths at ten years were calculated. Clinical and echocardiographic variables probably linked with the evolution of these patients were studied by uni and multivariate analysis, and the independent risk factors of cardiovascular events and cardiovascular death were identified. Based on the presence of these risk factors, risk estimation tables were constructed. Results: the rate of events for 100 patients at 10 years were: stroke: 3,63; rupture of mitral chordae: 1,69; infective endocarditis: 1,20; mitral valve surgery: 9,35; cardiovascular death: 11,3; combined cardiovascular events: 24,25. The resultant predictors of cardiovascular events and cardiovascular death, by univariate analysis were: male gender, age ³ 50 years, severe mitral regurgitation, previous rupture of mitral chordae, left atrial diameter ³ 40 mm, and end diastolic left ventricular diameter ³ 60 mm. Independent predictors of cardiovascular events, by multivariate analysis, were the same risk factors, except rupture of mitral chordae. Relating cardiovascular death, same factors, except rupture of mitral chordae and end diastolic left ventricular diameter were independent predictors. Conclusions: the benign character of MVP is confirmed, but the association of independent predictor risk factors identifies subgroups of patients with bad prognosis

Keywords : MITRAL VALVE PROLAPSE; CLINICAL EVOLUTION; RISK FACTORS.

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