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(Stroke. 2003;34:1345.)
© 2003 American Heart Association, Inc.

Original Contributions

Editorial Comment: Is MVP an MVP in Ischemic Cerebral Events?

NJ Neuroscience Institute, Department of Neurology and Medicine, Johns Hopkins University School of Medicine

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Support for mitral valve prolapse (MVP) as a source of cardiac embolism has undergone undulating cycles of enthusiasm over the past 25 years. When the association between stroke and MVP was mooted by the pioneering work of Barnett and colleagues,¹ a new referral source opened for cardiologists. Then came the backlash. Many cases appeared to be incidental; studies did not identify an increased risk of cerebral embolism²; the condition was deemed to be a harmless variant, and common in the general population. Revised diagnostic criteria followed, and MVP was all but removed as a "most valuable player" in the team of cardiac abnormalities associated with cerebral embolism. The confounding associations did not help: MVP may be idiopathic and solitary with either familial or sporadic forms. Alternatively it may be secondary to connective tissue disorders or ischemic heart disease (a common cause in those over 50 years of age). In addition, both ventricular and atrial arrhythmias can accompany MVP; there are anatomic variants as well, with different degrees of myxomatous degeneration of the posterior or anterior leaflet, and of papillary muscle involvement and mitral regurgitation. Thus embedded in the condition are many subvariants with a range of embolic potential from benign to extremely severe.

Avierinos and colleagues³ have to some extent pulled a rabbit out of the magician’s hat. Using the Olmsted County database, they were able to overcome some methodological flaws confounding earlier studies. A community reference base was used rather than that derived from hospital or ambulatory care . . . [Full Text of this Article]

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				Is Mitral Valve Prolapse Linked with Cerebral Ischemic Events? Journal Watch Cardiology, August 1, 2003; 2003(801): 6 - 6. [Full Text]