Abstract 12116: Familial Clustering of Mitral Valve Prolapse in the Community
Introduction: Our knowledge of mitral valve prolapse (MVP) inheritance is based on anecdotal evidence, case reports in selected individuals with late systolic clicks or prior M-mode echocardiographic diagnostic criteria. However, the extent of familial clustering of MVP among unselected individuals in the community based on current, more specific echocardiographic criteria is unknown.
Hypothesis: We hypothesized that parental MVP increases the risk of having MVP in the Framingham Heart Study (FHS).
Methods: Study participants were 3679 Generation 3 (Gen 3) individuals at Exam 1 with parents identified in either the Offspring (Exam 6 or 8) or the New Offspring Spouse cohort (Exam 1). Study participants with at least one parent with MVP (n = 186) were compared with a referent group of Gen 3 individuals without parental MVP (n = 3493) relative to MVP risk. MVP was diagnosed blinded to parental MVP status as leaflet displacement > 2 mm beyond the mitral annulus in a long-axis view at end-systole.
Results: Among 3679 participants, 49 had MVP (53% female; mean age 40±8 years). Compared with no parental MVP, MVP in one or both parents increased the risk of MVP in Gen 3 [10/49 (20%) versus 176/1630 (5%); multivariable (age, sex, systolic/diastolic blood pressure, and body mass index-BMI) -adjusted odds ratio (OR), 5.5; 95% confidence interval (CI), 2.6-11.9; p≤0.0001]. The risk of MVP in Gen 3 remained significant even when paternal and maternal MVP were considered separately (multivariable-adjusted OR, 5.4; 95% CI, 1.9-15.0; p=0.001 and OR, 6.0; 95% CI, 2.4-15.2; p=0.0001, respectively) (Figure).
Conclusions: Parental MVP is associated with increased risk of offspring MVP in the community. Familial clustering of MVP suggests the need for routine screening of family members in the community and motivates additional studies to elucidate the genetic underpinnings of this condition.
- © 2013 by American Heart Association, Inc.