Sonaglioni Andrea, Nicolosi Gian Luigi, Bruno Antonino, Lombardo Michele, Muti Paola
Division of Cardiology, IRCCS MultiMedica, 20123 Milan, Italy.
Division of Cardiology, Policlinico San Giorgio, 33170 Pordenone, Italy.
J Clin Med. 2024 Oct 16;13(20):6160. doi: 10.3390/jcm13206160.
Over the last five decades, a fair number of echocardiographic studies have evaluated the prevalence of mitral valve prolapse (MVP) in various cohorts of individuals, including heterogeneous study populations. The present systematic review has been primarily designed to summarize the main findings of these studies and to estimate the overall MVP prevalence in the general community. All echocardiographic studies assessing the MVP prevalence in various cohorts of individuals, selected from PubMed and EMBASE databases, were included. There was no limitation of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The full texts of 21 studies with 1354 MVP individuals out of 63,723 participants were analyzed. The overall pooled prevalence of MVP was 4.9% (range of 0.6-21%). When dividing the studies in two groups according to the echocardiographic criteria used for MVP diagnosis (less specific old criteria or more specific new criteria, respectively), the estimated pooled prevalence of MVP was 7.8% (range of 2-21%) for the older studies (performed between 1976 and 1998) and 2.2% (range of 0.6-4.2%) for the more recent ones (conducted between 1999 and 2021). Potential selection bias, hospital- or referral-based series, and the use of less specific echocardiographic criteria for MVP diagnosis have been indicated as the main reasons for the higher MVP prevalence detected by the older studies. MVP was commonly associated with a narrow antero-posterior thoracic diameter, isolated ventricular premature beats and nonspecific ST-T-wave abnormalities on a resting electrocardiogram, mild-to-moderate mitral regurgitation (MR), the reduced probability of obstructive coronary artery disease, and a low frequency of serious complications, such as severe MR, infective endocarditis, heart failure, stroke, and atrial fibrillation. MVP has a low prevalence in the general population, regardless of age, gender, and ethnicity, and is associated with a good outcome.
在过去的五十年里，相当多的超声心动图研究评估了二尖瓣脱垂（MVP）在包括异质性研究人群在内的各类个体队列中的患病率。本系统评价主要旨在总结这些研究的主要发现，并估计普通人群中MVP的总体患病率。纳入了所有从PubMed和EMBASE数据库中选取的评估各类个体队列中MVP患病率的超声心动图研究，且无时间限制。采用美国国立卫生研究院（NIH）观察性队列和横断面研究质量评估工具评估偏倚风险。对21项研究的全文进行了分析，这些研究共有63723名参与者，其中1354人患有MVP。MVP的总体合并患病率为4.9%（范围为0.6 - 21%）。根据用于MVP诊断的超声心动图标准（分别为不太特异的旧标准或更特异的新标准）将研究分为两组时，较旧研究（1976年至1998年进行）中MVP的估计合并患病率为7.8%（范围为2 - 21%），较新研究（1999年至2021年进行）中为2.2%（范围为0.6 - 4.2%）。潜在的选择偏倚、基于医院或转诊的系列研究以及使用不太特异的超声心动图标准进行MVP诊断被指出是较旧研究中检测到较高MVP患病率的主要原因。MVP通常与前后胸径狭窄、孤立性室性早搏以及静息心电图上的非特异性ST - T波异常、轻度至中度二尖瓣反流（MR）、阻塞性冠状动脉疾病的概率降低以及严重并发症（如严重MR、感染性心内膜炎、心力衰竭、中风和房颤）的低发生率相关。无论年龄、性别和种族如何，MVP在普通人群中的患病率较低，且预后良好。
