Kazan medical journalKazan medical journal0368-48142587-9359Eco-Vector1050410.17816/KMJ2018-906Research ArticleFunctional state of the myocardium and criteria for poor prognosis in mitral valve prolapseGadzhievaL Rdr_Gadzhieva@mail.ruMurachevaN Vdr_Gadzhieva@mail.ruTkachenkoS Bdr_Gadzhieva@mail.ruMain Military Clinical Hospital of the National Guard of Russia2511201899690691026112018Copyright © 2018, Gadzhieva L.R., Muracheva N.V., Tkachenko S.B.2018<p><strong>Aim.</strong> Study of the fnctional state of left ventricular myocardium and determination of diagnostic criteria of poor prognosis of mitral valve prolapse.</p>
<p><strong>Methods.</strong> 151 patients (116 males and 35 females) with mitral valve prolapse (MVP) were examined. The average age was 34.8 0.79 years. Division by the groups was performed depending on the severity of structural changes of the valve and width of the cusps: group 1 included 54 patients with classic form of MVP (cusp width 5 mm), group 2 included 55 patients with cusp width 3 mm, group 3 included 42 patients with MV cusp width less than 3 mm. All patients underwent complex clinical functional examination of cardiovascular system. The state of systolic and diastolic cardiac function was assessed using stationary high-tech ultrasound scanner Philips iE-33 (Philips, Holland) according to conventional technique with determination of standard heart parameters and calculation of intracardiac hemodynamic parameters. Echocardiography was performed on admission and 12 to 18 month later.</p>
<p><strong>Results.</strong> The study revealed that the most prominent changes of cardiohemodynamics and unfavorable disease course were observed in 72.2 % of patients with classic form of MVP (group 1). Patients with non-classic form of MVP (group 2) also had poor prognosis in 27.8 % of cases. Diagnostic criteria of poor prognosis of MVP according to echocardiography were determined: severe mitral regurgitation (degree III), mitral valve cusp thickness during diastole over 6 mm, left ventricle dilation (EDS 60 mm; ESS 36 mm), left atrial dilation (anterior posterior size of LA 40 mm, LA volume 80 ml), mitral annulus dilation (diameter of MA 35 mm).</p>
<p><strong>Conclusion.</strong> Differences of functional state of the myocardium of left ventricle were revealed depending on the type of mitral valve prolapse caused by the severity of connective tissue dysplasia. In classic form of MVP more severe disorders of intracardiac hemodynamics were observed as well as more severe mitral insufficiency.</p>mitral valve prolapsepoor prognosisпролапс митрального клапананеблагоприятный прогноз[Abdrakhmanova A.I., Abdulyanov I.V. Mitral valve prolapse in medical practice. Prakticheskaya meditsina. 2015; (3-2): 17–24. (In Russ.)][Vahanian A., Alfieri O., Andreotti F., et al. Guidelines on the management of valvular heart disease (version 2012). Eur. Heart J. 2012; 19: 2451–2496. DOI: 10.1093/][eurheartj/ehs109.][Nazarov V.M., Afanas’ev A.V., Demin I.I. Correction of mitral insufficiency in Barlow disease. Circulation pathology and cardiac surgery. 2014; (1): 70–73. (In Russ.)][Bova A.A., Rudoy A.S., Lysyy Yu.S. Mitral valve prolapse: errors of diagnosis, expert approaches. Meditsinskie novosti. 2011; (11): 17–21. (In Russ.)][Malev E.G., Zemtsovskiy E.V., Zhelninova T.A. et al. The incidence of mitral valve prolapse in the Russian population. Translyatsionnaya meditsina. 2011; (5): 113–118. (In Russ.)][Кужель Д.А., Матюшин Г.В., Савченко Е.А. Диаг-][Kuzhel’ D.A., Matyushin G.V., Savchenko E.A. Diagnosis and treatment of mitral valve prolapse. Ratsional'naya farmakoterapiya v kardiologii. 2010; 6 (4): 539–542. (In Russ.)][Hereditary connective tissue disorders in cardiology. Diagnosis and treatment. Russian guidelines (revision). Rossiyskiy kardiologicheskiy zhurnal. 2013; (1 s1): 2–32. (In Russ.)]