Carbone Andreina, D'Andrea Antonello, Scognamiglio Giancarlo, Scarafile Raffaella, Tocci Gianpaolo, Sperlongano Simona, Martone Francesca, Radmilovic Juri, D'Amato Marianna, Liccardo Biagio, Scherillo Marino, Galderisi Maurizio, Golino Paolo
Luigi Vanvitelli University, Monaldi Hospital, AORN Ospedali Dei Colli, Naples, Italy.
Rummo Hospital, Benevento, Italy.
J Cardiovasc Echogr. 2018 Oct-Dec;28(4):207-217. doi: 10.4103/jcecho.jcecho_42_18.
Mitral valve prolapse is generally a benign condition characterized by fibromyxomatous changes of the mitral leaflet with displacement into the left atrium and late-systolic regurgitation. Although it is an old clinical entity, it still arouses perplexity in diagnosis and clinical management. Complications, such as mitral regurgitation (MR), atrial fibrillation, congestive heart failure, endocarditis, ventricular arrhythmias, and sudden cardiac death (SCD), have been reported. A large proportion of the overall causes of SCD in young competitive athletes is explained by mitral valve prolapse. Recent studies have shown the fibrosis of the papillary muscles and inferobasal left ventricular wall in mitral valve prolapse, suggesting a possible origin of ventricular fatal arrhythmias. Athletes with mitral valve prolapse and MR should undergo annual evaluations including physical examination, echocardiogram, and exercise stress testing to evaluate the cardiovascular risks of competitive sports and obtain the eligibility. In this setting, multimodality imaging techniques - echocardiography, cardiac magnetic resonance, and cardiac computed tomography - should provide a broad spectrum of information, from diagnosis to clinical management of the major clinical profiles of the disease.
二尖瓣脱垂通常是一种良性疾病，其特征为二尖瓣叶发生纤维黏液瘤样改变，并向左心房移位以及晚期收缩期反流。尽管它是一个古老的临床实体，但在诊断和临床管理方面仍令人困惑。已报告了诸如二尖瓣反流（MR）、心房颤动、充血性心力衰竭、心内膜炎、室性心律失常和心源性猝死（SCD）等并发症。年轻竞技运动员心源性猝死的总体病因中有很大一部分可归因于二尖瓣脱垂。最近的研究显示二尖瓣脱垂患者存在乳头肌和左心室下基底壁纤维化，提示可能是室性致命性心律失常的起源。患有二尖瓣脱垂和二尖瓣反流的运动员应每年接受评估，包括体格检查、超声心动图和运动负荷试验，以评估竞技运动的心血管风险并确定是否具备参赛资格。在这种情况下，多模态成像技术——超声心动图、心脏磁共振成像和心脏计算机断层扫描——应能提供从疾病诊断到主要临床特征临床管理的广泛信息。
