Malkowski M J, Guo R, Orsinelli D A, Wooley C F, Tice F D, Pearson A C, Boudoulas H
Ohio State University, Division of Cardiology, USA.
J Heart Valve Dis. 1997 Jan;6(1):54-9.
Mitral valve prolapse due to floppy mitral valve (MVP/FMV) is a common valvular abnormality with a variable clinical course. Flail mitral valve leaflet resulting in severe mitral regurgitation is a complication of MVP/FMV.
In order to understand the structural correlates of flail mitral valve leaflet in MVP, we reviewed the morphologic characteristics of the mitral valve by transesophageal echocardiography (TEE) in 72 patients (24 normal; 26 mitral valve prolapse; 22 flail mitral valve leaflet).
Compared with the normal group, the mitral valve prolapse group had greater anterior and posterior mitral valve leaflet thickness and anterior mitral valve leaflet length. Patients with flail mitral valve leaflets as a complication of FMV had greater anterior and posterior mitral valve leaflet length and posterior mitral valve leaflet thickness compared with MVP patients without flail mitral valve leaflets. Posterior mitral valve leaflet length was the only echocardiographic independent predictor of flail mitral valve leaflet. Older FMV patients with increased mitral valve leaflet length and thickness are predisposed to flail mitral valve leaflets and severe mitral regurgitation.
TEE may identify patients with MVP/FMV with the greatest structural abnormalities who are at risk for complications such as flail mitral valve leaflet(s).
因二尖瓣黏液样变性所致二尖瓣脱垂（MVP/FMV）是一种临床病程多变的常见瓣膜异常。连枷样二尖瓣叶导致严重二尖瓣反流是MVP/FMV的一种并发症。
为了解MVP中连枷样二尖瓣叶的结构相关性，我们通过经食管超声心动图（TEE）回顾了72例患者（24例正常；26例二尖瓣脱垂；22例连枷样二尖瓣叶）二尖瓣的形态学特征。
与正常组相比，二尖瓣脱垂组二尖瓣前后叶厚度及前叶长度更大。作为FMV并发症的连枷样二尖瓣叶患者与无连枷样二尖瓣叶的MVP患者相比，二尖瓣前后叶长度及后叶厚度更大。二尖瓣后叶长度是连枷样二尖瓣叶唯一的超声心动图独立预测指标。年龄较大、二尖瓣叶长度和厚度增加的FMV患者易发生连枷样二尖瓣叶及严重二尖瓣反流。
TEE可识别出MVP/FMV中结构异常最严重、有发生连枷样二尖瓣叶等并发症风险的患者。
