ROCHESTER, Minn. - Disturbing evidence of higher mortality and lower surgery rates in women versus men with mitral valve prolapse and severe leakage may be related to the complexity of evaluating the condition's severity in women, according to findings of a Mayo Clinic study published this month in the Annals of Internal Medicine.
Mitral valve prolapse affects approximately 150 million people worldwide and often requires cardiac surgery, preferably valve repair rather than replacement, to restore life expectancy of patients with severe leakage, says senior author Maurice Enriquez-Sarano, M.D., a cardiologist at Mayo Clinic. Cardiac valves allow the heart to move blood forward without leakage. Mitral valve prolapse occurs when the leaflets and supporting cords of the mitral valve have excessive tissue and weaken, leading to leakage (regurgitation), he says.
Previous studies on mitral valve disease have examined several sex-based differences, discovering, for example, that mitral valve prolapse is more common in women than men, and that more men than women undergo mitral valve surgery.
This retrospective study examined more than 8,000 patients (4,461 women and 3,768 men) - all patients at Mayo Clinic diagnosed by echocardiography with mitral valve prolapse over 10 years (1989 to 1998).
"This study is significant because it allowed us to look at a large group of patients affected by mitral valve prolapse and examine subtle sex-specific differences that may have been overlooked in the past," Dr. Enriquez-Sarano says. "This study may help physicians manage mitral valve prolapse in women better, more precisely identify women with mitral valve prolapse and severe regurgitation, and treat them - possibly with surgery, which can be lifesaving."
Disturbing differences were observed in men and women with moderate or severe regurgitation - when the mitral valve doesn't close tightly and leaks, with blood flowing backward
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