PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS BY \ DR: Dhaifullah Jayed Ass.Prof:Thamar Uni Consultant Cardiologist DR: Mohammed Al-yazidi Consultant Cardiologist
GHA 10, SHA24. 13 FEB 2013
INTRODUCTION Mitral valve prolapse (MVP) is a condition characterized
by systolic displacement of an abnormally thickened, redundant mitral valve leaflets into the left atrium during systole¹. Mitral valve prolapse is a common cardiac disorder, with prevalence generally ranging from 5-15 percent in most of studies and up to 35 percent in some studies¹¹⁻¹⁷. MVP is associated with several complications such as bacterial endocarditis, severe mitral regurgitation, atrial fibrillation, syncope and stroke² ⁻⁷. PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Objectives
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Methods Study population: Study established in Al-Kuwait university hospital Sana'a
from 2004-2008 as a prospective study
Includes 1164 healthy Yemeni individuals, 615 women and
549 men, ranging in age from 18-70 years with (mean age ± SD 45.7 ± 10 years). Population includes presumably healthy individuals accompanied the patients who have been referred for echocardiographic and abdominal ultrasonographic department.
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
: Two-dimensional echocardiography with commercially available system Sonos 5500,) Hewlett-Packard) that used a 2.5. MHz transducer
Echocardiography The 2-D echocardiographic criteria based on the 3-D shape of the annulus and clinical correlation were used to diagnose mitral valve prolapse according to the maximal superior displacement of the mitral valve leaflets during systole relative to the line connecting the annular-hing points. Thickness of the mitral valve leaflets during diastasis was measured from the leading to the trailing edge of the thickest area of the mid-portion of the leaflets.
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
NON-CLASSICAL PROLAPSE
CLASSICAL PROLAPSE
Classical prolapse if
Nonclassic prolapse if
displacement exceeded 2 mm and maximal thickness was at least 5mm.
displacement exceeded 2 mm but the maximal thickness was less than 5 mm
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
M.V.P. MEASURMENTS
THICKENING OF LEAFLETS IN DIASTOLE
MVP IN SYSTOLE
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
:Clinical characteristics
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Statistical analysis used statistical software (version 6.11, SAS institute, cary, N.C) in all calculations in our study.
1. MVP 2. NON-MVP
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Results PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Table 1 :Prevalence of Various Clinical Characteristics Characteristic s
Classical MVP )N= 40(
Chest pain
4 (10%)
Non-classical MVP (N= 34) 3 (8.8%)
Dyspnea Cigarette smoking Hypertension Diabetes mellitus Hypercholestr olemia
3 ( 7.5% )
3 (8.8% )
80(7.3%)
N.S
7 ( 17.5% )
6 ( 16.7% )
110(10.1%)
N.S
6 (15.0% )
5 (14.7% )
150(13.8%)
N.S
0
0
0
N.S
5 (12.5% )
6 (17.6% )
140(12.8%)
N.S
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
No MVP
P-value
( N= 1090) 95(8.7%)
N.S
by : Dr. Dhaifullah Jayed
Prevalence of mitral valve prolapse
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Table 3 : Prevalence of Various Clinical Findings According to the Presence or Absence of Mitral Valve Prolapse Clinical Findings
Mitral Valve Prolapse (N= 74)
No Mitral Valve Prolapse N=1090
Atrial fibrillation
0
0
Cerebrovascular disease.
1 ( 1.3% )
0
Syncope
2 ( 2.7% )
1( 0.09% )
Heart failure
0
0
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Table 4: PHYSICAL FINDINGS Variables Body-mass index ** waist-to-hip ratio ** Systolic BP mmHg *** Diastolic BP mmHg Systolic murmur **** Mid-systolic click ****
Classic MVP
No MVP
P- values*
23.1± 0.1
)N= 1090 ( 26.1± 0.2
< 0.001
0.8 ± 0.11
0.79 ± 0.01
0.89 ± 0.001
0.007
120 ± 1.3
120.1.2
123 ± 0.1
N.S
70 ± 0.1
70 ± 0.4
72 ± 0.2
N.S
20 ( 50% )
16 ( 47.1% )
45 ( 4.1% )
< 0.001
19 ( 47.5% )
11 ( 32.3% )
3 (0.3% )
< 0.001
) N= 40) 23.3 ± 0.3
Non-classic MVP )N = 34)
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Table 5 : E.C.G. FINDINGS Variables
Classic MVP
Non-classic MVP
No MVP
) N= 40)
)N = 34)
)N= 1090 (
Atrial ectopy
3 ( 7.5 % )
1 (2.9% )
15(1.4%)
V. ectopy
1 ( 2.5% )
0
0
N.S
L.A.E.
0
0
0
N.S
L.V.H.
0
0
0
N.S
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
P- values*
< 0.05
by : Dr. Dhaifullah Jayed
DISCUSSION
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Mitral valve prolapse has been described as the most common cardiac valvular abnormality in industrialized countries²². Previous studies show a large variations of prevalence ranging from 5% upto 35%¹¹⁻¹⁷, but the subjects have largely been volunteers¹²¹³¹ ̓ ̓ ⁶, some self referred and some self selected. In two studies¹³¹̓ ⁶, subjects were selected from large clinic or hospital practices. Such studies are subjects to select many bias and did not reflect prevalence in general population. In addition to that, previous studies used old criteria for diagnosing MVP by echocardiography. PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
New criteria as mentioned above has revealed marked reduction in prevalence of mitral valve prolapse by several recent studies to be on the range of 2-4% in general population studies²⁷ Our present study show a prevalence of mitral valve prolapse by 6.3% which is between the higher prevalence seen on many previous studies¹¹¹², ̓ and near the lower prevalence revealed by framingham heart study²⁷, which is considered comminuty-based study, and consistent with other study¹³. Chest pain, dyspnea were similar in the group of subjects with mitral valve prolapse and those without prolapse and that is consistent with previous reports²³²̓ ⁶. PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
CONCLUSION
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
Conclusion The prevalence of mitral valve prolapse in adult
Yemenis was 6.3 percent which is similar to other studies in different countries The low prevalence of adverse sequelae in our study in compare to other studies is explained by the nonselective general popoulation based study we applied.
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
REFERENCES
PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
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by : Dr. Dhaifullah Jayed
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PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
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PREVALENCE OF MITRAL VALVE PROLAPSE AND ITS ADVERSE SEQUELAE IN HEALTHY ADULT YEMENIS
by : Dr. Dhaifullah Jayed
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