Echocardiographically documented mitral-valve prolapse. Long-term follow-up of 237 patients

N Engl J Med. 1985 Nov 21;313(21):1305-9. doi: 10.1056/NEJM198511213132101.


We determined the long-term prognosis for patients with mitral-valve prolapse documented by echocardiography by following 237 minimally symptomatic or asymptomatic patients for a mean of 6.2 years (range, 1 to 10.4). The actuarial eight-year probability of survival was 88 per cent, which is not significantly different from that for a matched control population. An initial left ventricular diastolic dimension exceeding 60 mm was the best echocardiographic predictor of the subsequent need for mitral-valve replacement (17 patients). Of the 97 patients with redundant mitral-valve leaflets identified echocardiographically, 10 (10.3 per cent) had sudden death, infective endocarditis, or a cerebral embolic event; in contrast, of the 140 patients with nonredundant valves, only 1 (0.7 per cent) had such complications (P less than 0.001). Most patients with echocardiographic evidence of mitral-valve prolapse have a benign course, but subsets at high risk for the development of progressive mitral regurgitation, sudden death, cerebral embolic events, or infective endocarditis can be identified by echocardiography.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Death, Sudden
  • Echocardiography*
  • Endocarditis, Bacterial / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Embolism and Thrombosis / etiology
  • Male
  • Middle Aged
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency / surgery
  • Mitral Valve Prolapse / complications
  • Mitral Valve Prolapse / diagnosis*
  • Mitral Valve Prolapse / mortality