Clinical and functional features of mitral valve prolapse in adolescents

Abstract

Aim. To investigate the features of hemodynamic changes and autonomic regulation in adolescents with Stage I-II mitral valve prolapse (MVP).
Material and methods. In total, 112 adolescents with MPV underwent clinical examination, Doppler ultrasound, and cardiointervalography.
Results. Stage I MVP was associated with predominantly autonomic symptoms in 72,7 % of the patients; in 59,5 %, increased sympathetic activation was observed. In Stage II MPV patients, connective tissue dysplasia was registered in 85,4 %, with predominant parasympathetic effects in 47,4 %. Mitral valve visualization (B-mode Doppler ultrasound) demonstrated changes in the valve structure in 49,5 % and 5,4 % of Stage II and I MVP patients, respectively (p<0,001). During clino-orthostatic test, adolescents with MVP had inadequate hemodynamic reaction, especially in Stage II MVP.
Conclusion. Сlinical and functional features were explained by the pathogenetic mechanisms of Stage I and II MVP: the former was characterised by increased sympathetic activation, decreased left ventricular volume, and predominance of chordae and leaflets over mitral annulus; the latter was characterised by inadequacy of valve connective tissue, as a manifestation of connective tissue dysplasia syndrome.