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Mitral valve prolapse (MVP) is the most common cardiac valvular abnormality in industrialized countries. Its prevalence has been estimated around 2.4%, ranging from 2% to 4%. The purpose of this study was to determine the prevalence, demographic, clinical and echocardiographic characteristics of MVP in a large population-based epidemiologic study.
A total of 2298 subjects with a mean age of 50 (age range 18–92) living in Melen valley, which is inhabitant of 21 000 people were interviewed. An echocardiography machine utilizing 2-5 MHz probe specific for field studies (M Turbo, SonoSite Inc., Bothell, WA, USA) was used. The displacement of each leaflet was measured in the parasternal long-axis view above a line connecting the mid portions of the annular hinge points. The thickness of the mitral valve was measured by M mode recording. Each leaflet was measured, and maximal thickness was used for categorization. The degree of mitral regurgitation was assessed by the method recommend by current guideline. Thyroid ultrasonography: It was performed and interpreted by the same experienced physician, using the same equipment with a 5–12-MHz linear-array transducer (M Turbo, SonoSite Inc., Bothell, WA, USA). Size of the thyroid lobes and characteristics of thyroid parenchyma and nodules were determined. Goiter prevalence was defined according to Gutekunst's criteria. Gutekunst reference values for adults (>18 cm3 in women and >25 cm3 in men) were used. Hyper and hypothyroidism: A thyroid stimulating hormone (TSH) level of <0.35 μIU/mL was accepted as hyperthyroidism and >4.5 μIU/mL as hypothyroidism. Major depression: The questionnaire included an extensive list of questions that operationalize DSM-IV criteria for major depression. The participants who refused echocardiography measurement and had poor image quality and blood sampling were excluded
The final cohort included 2,228 participants (1,424 women 804 men, with a mean age of 49±15). The echocardiographic prevalence of MVP was 0.36%. The prevalence of MVP was 0.35% in female (n=5) and 0.37% in male (n=3) patients. The mean age of patients with MVP was 39±10.7 years (22-53). Four patients (50%) had prolapse of the anterior leaflet, 1 (12.5%) had prolapse of the posterior leaflet and 2 (25%) had prolapse of both anterior and posterior leaflet. Only one patient had mild mitral regurgitation on color Doppler echocardiography. Baseline demographic and clinical characteristics of patients; 1 (12.5%) had hypertension, 3 (37.5%) had depression, 1 (12.5%) had migraine, 1 (12.5%) had diabetes mellitus, 1 (12.5%) had diastolic dysfunction, 3 (37.5%) had nodular goiter, 2 (25%) had hyperthyroidism. During the follow-up of 36 months, no major adverse events occurred.
This finding suggests that the prevalence of MVP was lower than previously studies and there might be a relationship between MVP and goiter, and depression.