Sasaki H, Ogawa S, Handa S, Nakamura Y, Yamada R
J Cardiogr. 1982 Mar;12(1):23-31.
We studied the prevalence of mitral valve prolapse (MVP) in presumably healthy young students using two-dimensional echocardiography and compared their clinical pictures with those of hospital patients with MVP. In 265 students undergoing routine physical examination (228 males and 37 females, aged from 18 to 25 years), 29 (11%) were diagnosed as having MVP. There was no sex difference (11% for males and 8% for females). Anterior leaflet prolapse was seen in 26 cases, and anterior and posterior leaflets prolapse was in 3 cases. Twenty-four of the 29 MVP students revealed neither midsystolic click, late systolic murmur nor holosystolic murmur on phonocardiograms (PCG). These 24 students had no cardiac symptoms and the incidence of electrocardiographic (ECG) abnormalities, such as arrhythmias and ST-T changes, was similar to that of students without MVP (4/24 vs 50/236). In contrast, of 54 patients (32 males and 22 females, aged from 15 to 25 years) who were diagnosed as having MVP in the hospital, 28 patients (52%) had no PCG abnormalities. The anterior leaflet was predominantly involved in 42 patients and both anterior and posterior leaflets in 12 patients. These 28 patients visited the hospital because of cardiac symptoms; dyspnea on exertion (3 patients), palpitation (2 patients) or atypical chest pain (7 patients), or abnormal physical examination (11 patients). ECG abnormalities were noticed in 15 of 28 patients (54%). The prevalence of cardiac symptoms and ECG abnormalities were similar to those in 26 patients with PCG evidence of MVP. It was concluded that the prevalence of MVP in young healthy students is 11% and the anterior leaflet is predominantly involved. Most cases were asymptomatic and had no PCG or ECG abnormalities. In contrast, age-matched MVP patients, diagnosed in the hospital with the same two-dimensional echocardiographic criteria, demonstrated similar predominancy of the anterior leaflet prolapse, but had more cardiac symptoms and ECG abnormalities, irrespective of the presence or absence of PCG findings.
我们使用二维超声心动图研究了看似健康的年轻学生中二尖瓣脱垂（MVP）的患病率，并将他们的临床表现与医院中MVP患者的临床表现进行了比较。在265名接受常规体检的学生中（228名男性和37名女性，年龄在18至25岁之间），29名（11%）被诊断为患有MVP。没有性别差异（男性为11%，女性为8%）。26例可见前叶脱垂，3例为前后叶脱垂。29名MVP学生中有24名在心音图（PCG）上既未发现收缩中期喀喇音、收缩晚期杂音也未发现全收缩期杂音。这24名学生没有心脏症状，心电图（ECG）异常（如心律失常和ST-T改变）的发生率与没有MVP的学生相似（24名中有4名 vs 236名中有50名）。相比之下，在医院中被诊断为患有MVP的54名患者（32名男性和22名女性，年龄在15至25岁之间）中，28名患者（52%）没有PCG异常。42例以前叶受累为主，12例前后叶均受累。这28名患者因心脏症状就诊；劳力性呼吸困难（3例）、心悸（2例）或非典型胸痛（7例），或体格检查异常（11例）。28名患者中有15名（54%）发现心电图异常。心脏症状和心电图异常的患病率与26例有PCG证据的MVP患者相似。得出的结论是，年轻健康学生中MVP的患病率为11%，且以前叶受累为主。大多数病例无症状，没有PCG或ECG异常。相比之下，在医院中根据相同的二维超声心动图标准诊断的年龄匹配的MVP患者，前叶脱垂的优势相似，但无论有无PCG表现，都有更多的心脏症状和ECG异常。
