Mitral valve prolapse and coronary artery disease. Clinical, hemodynamic, and angiographic correlations.

• DOI: 10.1161/01.cir.52.2.245
• Publication Date: 2012-06-11T23:57:40Z
• Authors: J M Aranda; B Befeler; R Lazzara; A Embi; H Machado
• Keywords: Contractility; Mitral valve prolapse; Papillary muscle; Preload

Among 95 patients with angina pectoris and angiographically documented coronary artery disease (CAD), prolapse of the scallops posterior leaflet mitral valve (PLMV) was noted in 30 patients. Left ventriculograms right anterior oblique (RAO) projection revealed isolated posteromedial commissural scallop (PMCS) 12 anterolateral (ALCS) two Seven had both PMCS ALCS, three middle (MS), six all PLMV. ventricular dilatation increase trabeculations observed 19 Contractility determined a quantitative fashion by segmental motion analysis markedly impaired 29 None angiographic evidence insufficiency. dysfunction 28 either elevated left end-diastolic pressure (LVEDP), low cardiac index (CI) or decreased ejection fraction (EF). In whom contractility improved after aortocoronary pass, previously prolapsed could not be identified postoperative ventriculogram. Prolapsed PLMV is frequent finding CAD. Impaired myocardium papillary muscles, dilatation, hypertrophy appear to play significant role pathogenesis this abnormality through distortion directional axis asynergic contraction related free wall ventricle, changes normal spatial alignment necessary for closure. The syndrome muscle represents wider clinical spectrom than described.