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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-five consecutive patients with systemic lupus erythematosus were enrolled in a prospective study. Investigations included a physical evaluation, tests for antinuclear antibodies and antiphospholipid antibodies, an electrocardiogram, a plain chest film, a 2D echocardiogram and a Doppler study. Clinical cardiac manifestations and alterations of the electrocardiogram were infrequent (17% and 11% of patients, respectively) and no patients had abnormal chest film findings. In contrast, echocardiographic abnormalities were common (82% of patients), although moderate in most instances. Pericardial involvement was found in 15 patients (42.8%); a pericardial effusion was seen in 9 of the 14 patients with inactive disease (p < 0.003), whereas thickening of the pericardium was visible in 4 patients with active disease and 2 of the 21 patients with inactive disease. Valve abnormalities were found in 17 patients (48.5%), but were not related to the presence of antiphospholipid antibodies; valve alterations included verrucous endocarditis in one case, valve thickening in one case, mitral prolapse in five cases, and mild or moderate regurgitation in 15 cases (aortic in 2 cases, mitral in 7 cases, pulmonary in 3 cases and tricuspid in 7 cases). Alterations in ventricular chamber size and kinetics were also fairly common, albeit of uncertain pathogenetic significance. These data confirm the value of 2D echocardiography for identifying and monitoring cardiac involvement in systemic lupus erythematosus, even in patients with no overt clinical manifestations.
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PMID:[Evaluation of cardiac involvement in systemic lupus erythematosus. Clinical and echographic study]. 130 69

Similar morphologic abnormalities have often been observed in the leaflets of tricuspid valve in patients with mitral valve prolapse. In the present study, morphologic tricuspid valve prolapse was analyzed in 500 consecutive autopsies of the aged over 60 years (mean 78.5 yrs, 266 men, 234 women). Additionally, the sensitivity and specificity of the color Doppler technique applied before death were assessed in 61 autopsy cases. The results were as follows: 1. The incidence of morphologic tricuspid valve prolapse was 22.2% at autopsy in 500 cases of the aged, however, tricuspid regurgitation had not clinically been detected in any of them. 2. The prolapse of 2- or 3-leaflets was common (78.5%). Among the 3 leaflets, the prolapse was more frequently observed in the anterior or posterior leaflet than in the septal leaflet. Combined tricuspid and mitral valve prolapses were observed in 22 cases (19.8%). 3. Among 61 cases examined by color Doppler echocardiography, autopsy showed that 16 cases had tricuspid valve prolapse and 14 cases tricuspid regurgitant flow signals (87.5%). 4. Regurgitant flow signals were also detected in 4 of 12 morphologically normal cases (33.3%). 5. In autopsy cases of the aged, generally, the incidence of morphologic tricuspid valve prolapse and tricuspid regurgitant flow signal were high, however, hemodynamically significant regurgitation due to prolapse was very rare.
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PMID:[A clinicopathologic study of morphologic tricuspid valve prolapse in the aged: comparison with color Doppler evaluation]. 141 79

From 1986 to 1992 102 mitral valve repairs were done for mitral regurgitation due to a degenerative disease. Forty-eight patients had an anterior prolapse or prolapse of both leaflets at initial presentation and underwent chordal transposition from the mural leaflet to the anterior leaflet. The corrective procedure was completed by polytetrafluoroethylene or pericardial posterior annuloplasty. Operative mortality was 2.9%, and follow-up (average 22 months) was 100% complete. There were three postreconstruction valve replacements (one earlier and two later) for a probability of freedom from reoperation of 91.5% +/- 5.2% at 3 years. Freedom from all morbidity was 85.5% +/- 5.5% at 3 years. Postoperative echocardiographic studies demonstrated a good mitral valve function: (1) Eighty-seven percent of patients presented no or mild residual regurgitation; (2) transmitral flow indexes were within the norm; (3) left ventricular outflow tract flow was normal in all patients. This study shows that chordal transposition is a safe and effective technique for prolapse of anterior or both leaflets and improves the chances of repair in patients with mitral degenerative disease.
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PMID:Correction of anterior mitral prolapse. Results of chordal transposition. 143 4

Three decades after it was demonstrated that nonejection systolic clicks and late systolic murmurs have a mitral valve origin and that a specific syndrome is associated with the primary degenerative mitral lesion, numerous questions remain unanswered. A principal cause of confusion is the use of the term 'prolapse', which essentially implies a pathological state, in many patients with minimal evidence of a mitral valve anomaly. It should be recognised that no specific feature, whether evaluated by high standard echocardiography or indeed by careful morphological and histological examination, can be defined which distinguishes a normal variant from a pathological valve. There is a gradation from the normal billowing during ventricular systole of mitral leaflet bodies to marked billowing. With advanced billowing or floppy leaflets, failure of leaflet edge apposition supervenes (true prolapse). This is functionally abnormal and allows mitral regurgitation. Prolapse in turn may progress to a flail leaflet and hence gross regurgitation. Relatively rare complications of this degenerative mitral valve anomaly include systemic emboli, infective endocarditis, arrhythmias and, arguably, autonomic nervous system abnormalities. An attempt is made to clarify the management of some symptoms and other aspects of mitral prolapse-including rheumatic anterior leaflet prolapse (without billowing) which remains prevalent in South Africa and Third World countries.
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PMID:Mitral valve billowing and prolapse--an overview. 144 36

Fulminating active rheumatic carditis has been observed for over 3 decades in this environment with no recent alteration in either the incidence or the pattern of presentation. Patients are black, seldom older than 20 years and are usually in their early teens but may occasionally be as young as five years. Heart failure is prevalent but occurs only when a haemodynamically important left-sided valve lesion supervenes. Regurgitation is the predominant valve lesion and involves principally the mitral valve. Mitral annular dilatation is the initial pathology and predisposes to lengthening--or rupture--of chordae tendineae and prolapse of the anterior leaflet. The resultant cardiac work-overload apparently perpetuates the rheumatic activity. Heart failure, whether caused by or associated with active rheumatic carditis, makes surgical management of the valve lesion mandatory as a life-saving measure. Mitral valve repair, rather than replacement, is the surgical procedure of choice but is not always practicable when the rheumatic activity is fulminant, significant aortic regurgitation associated or the surgeon relatively inexperienced. Aggressive medical therapy for heart failure, which should include vasodilator drugs, provides temporary improvement only. Contrary to ongoing doctrine, treatment with steroid drugs is neither life-saving nor beneficial. Varying degrees of left ventricular dysfunction are encountered pre-operatively and may be a sequel of the severe regurgitant valve lesion rather than of a rheumatic 'myocardial factor'.
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PMID:Aspects of active rheumatic carditis. 144 46

Marfan syndrome is very rarely diagnosed in the neonate, and specific pathological and clinical findings are described in this age; cardiac involvement occurs very often, carrying severe prognosis in most patients. In the presented case the diagnosis was suspected according to clinical findings; bidimensional echocardiography showed that the most important lesion was tricuspid dysplasia and prolapse; Doppler echocardiography has contributed to explain the clinical severity, showing regurgitation of all cardiac valves and a pattern of functional tricuspid atresia. Autoptic examination has later confirmed all these findings.
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PMID:[The usefulness of Doppler echocardiography in the diagnosis of neonatal Marfan's syndrome. A clinical case report]. 158 25

To detect potential cardiac abnormalities induced by intravenous heroin use, 68 persons without a previous episode of infective endocarditis were studied by Doppler echocardiography. A control group of 41 normal subjects was studied for comparison. The following measurements were considered: (1) diameter of heart chambers, (2) systolic left ventricular function, (3) morphologic valvular abnormalities, (4) presence of valve regurgitations, (5) Doppler indexes of diastolic function, and (6) estimation of pulmonary arterial resistances. Results showed no significant differences regarding the size of the heart chambers or systolic left ventricular function. A significantly higher incidence of valvular abnormalities (focal thickening or valve prolapse) was found in drug addicts (p = 0.0009) at the mitral and tricuspid valves, as was valvular regurgitation detected by Doppler (p = 0.04). Also, a significantly prolonged deceleration time of mitral and tricuspid early diastolic Doppler flow was found in the study group (p = 0.0001 and 0.027, respectively) although a different hemodynamic condition in the study group (pharmacologically reduced preload) precluded these findings to be attributable to an actual diastolic dysfunction. No differences were observed in pulmonary arterial resistances. It is concluded that mitral and tricuspid valve abnormalities can be detected by echocardiography in asymptomatic intravenous heroin users, whereas no apparent effects are observed in morphologic or functional parameters of cardiac structures other than the valves.
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PMID:Findings on Doppler echocardiography in asymptomatic intravenous heroin users. 173 65

We studied surgical results of 14 cases of ischemic mitral regurgitation. There was no surgical death in 10 cases with left ventricular aneurysm, and their clinical symptoms improved except 3 with the combined operation of left ventricular aneurysmectomy, mitral annuloplasty and bypass grafting. The range of the abnormal contracting segment significantly decreased after surgery except in 3 cases in whom clinical status was not improved. Three of 4 cases which underwent bypass grafting and mitral annulo-valvuloplasty survived, but one of them died of graft-versus-host disease. In the three survived cases, severe mitral regurgitation disappeared. We have concluded as follows: In cases of left ventricular aneurysm, a sufficient aneurysmal resection is very important to control the mitral regurgitation, and the additional procedures of mitral annuloplasty and bypass grafting are essential. The mitral valve replacement is recommended in case of the complete disruption of the papillary muscle. Mitral valvuloplasty combined with annuloplasty is suitable to control the regurgitation in the regional mitral prolapse due to the torn chordae.
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PMID:[Surgical repair of ischemic mitral regurgitation]. 175 16

Echocardiogram examination of 250 young fighter pilots has revealed that 15 aviators had mitral valve prolapse (MVP) without symptoms of pronounced regurgitation. Their functional indexes of cardiovascular system at rest or dosed physical load at veloergometer tests were normal. Only in 3 pilots were marked rare supraventricular or ventricular extrasystoles during ECG monitoring or veloergometria. Performance capability of all pilots was sufficient. 13 pilots with MVP in examination of their tolerance to +Gz hypergravity at the levels of 6 G or more for 15 s had frequent polytop or group ventricular extrasystole. There was an ordinary aggravation of extrasystole in aviators with more deep and bilateral MVP. The article makes a conclusion that on the basis of medical flight expertise a thorough selection must be made concerning possibility of every pilot with MVP to carry out flight at high manoeuvring aircraft of new generation taking into account the gravity of prolapse and tolerance to high +Gz hypergravity more than 5 G.
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PMID:[Cardiovascular system function in mitral valve prolapse in fighter pilots]. 182 4

To investigate the continuity between the normal and prolapsed mitral valves (MVP), two-dimensional echocardiography (2DE) and color Doppler echocardiography (CDE) were performed in 508 healthy boys aged 12 to 13 years old. The distance from the plane of the mitral annulus to the coaptation of the mitral valve "c", the maximum distance between the anterior leaflet and a straight line connecting the anterior mitral annulus and the coaptation of the mitral valve "d", and the maximum distance between the posterior mitral leaflet and the straight line connecting the posterior mitral annulus and the coaptation of the mitral valve "e" were measured in the parasternal long-axis view. The locations of the anterior and posterior mitral annuli were determined to be the hing point of the anterior leaflet on the left ventricular side and the junction of the posterior leaflet on the ventricular side, respectively. Mitral regurgitation (MR) was evaluated by CDE in the parasternal long-axis view. The ratio of the duration of regurgitation to ejection time (DT/ET) was measured by M-mode CDE in the subjects with and without MVP. The values of "c" ranged from +10 mm to -3 mm, and those of "d" from +5 mm to -4 mm (minus denotes prolapse into the left atrium). Approximately normal distributions were demonstrated with the parameters "c" and "d". The value of "e" could not be measured because of a poor image of the posterior leaflet. The incidence of MVP varied from 2.5 to 13.5% depending on the criterion for applied MVP. Fifty-nine of the 487 healthy subjects turned out to have MR (12%). Coaptation of the mitral valve deviated from the posterior commissure significantly to the left atrium more in the subjects with MR than in those without MR (2.46 +/- 1.93 vs 3.41 +/- 1.84, p < 0.01). The DT/ET ratio of the MR subjects with MVP tended to be higher than that of the boys without MVP. The presence of continuity between the normal and prolapsed mitral valves suggests that MVP may be a multifactorial disorder of the valve. Associated asymptomatic MR may be related not only to the severity of MVP but also to other factors, especially in MR of normal healthy subjects.
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PMID:[Continuity from normal to prolapsed mitral valves: two-dimensional and color Doppler echocardiographic investigations]. 184 27


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