Von Willebrand Factor and Mitral Valve Prolapse

 

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Summary

The levels of von Willebrand factor (vWF: Ag) were measured in 27 patients with mitral valve prolapse (MVP) and compared to 27 age matched controls. Decreased levels of vWF:Ag (<80%) were found in 59% (16/27) of those with MVP compared to only 7% (2/27) of the controls (p <0.001). Mean vWF: Ag levels were also significantly lower in those with MVP (68 ± 30% versus 100 ± 23%, p <0.001). In those with MVP and congestive heart failure secondary to ruptured chordae tendineae, however, the mean level of vWF:Ag was not significantly different from control values (95 ± 32). There was an increased incidence of recurrent nose bleeds in those with MVP and low levels of vWF: Ag. We conclude that there is a relationship between MVP and low levels of vWF:Ag which may explain the increased incidence of epistaxis in such patients. Increased release of vWF: Ag in those with MVP and concomitant congestive heart failure may account for the normal levels found in this subgroup.

• References

• 1 Pyeritz RE, Wappel MA. Mitral valve dysfunction in the Marfan’s syndrome; clinical and echocardiographie study of the prevalence and natural history.. Am J Med 1983; 74: 797-807
  CrossrefPubMedGoogle Scholar
• 2 Lebwohl MG, Distefano D, Prioleau PG, Uram M, Yannuzzi LA, Fleischmayer R. Pseudoxanthoma elasticum and mitral valve prolapse.. N Engl J Med 1982; 307: 228-231
  CrossrefPubMedGoogle Scholar
• 3 Brant KD, Sumner RD, Ryan TJ, Cohen AS. Herniation of mitral valve leaflets in the Ehlers-Danlos syndrome.. Am J Cardiol 1975; 36: 524-528
  CrossrefPubMedGoogle Scholar
• 4 Savage DD, Garrison RJ, Devereux RB, Castelli WP, Anderson SJ, Levy D. et al Mitral valve prolapse in the general population. 1. epidemiologic features: the Framingham study.. Am Heart J 1983; 106: 571-576
  CrossrefPubMedGoogle Scholar
• 5 Pickering NJ, Brody JI, Barnett MJ. Von Willebrand’s syndrome and mitral-valve prolapse; linked mesenchymal dysplasia.. N Engl J Med 1981 305: 131-134
  PubMedGoogle Scholar
• 6 Kuhsel LC, Polster J, Rudiger HW. An investigation into the frequency of mitral valve prolapse in von Willebrand’s disease.. Clin Genet 1983; 24: 128-131
  PubMedGoogle Scholar
• 7 Wynne J. Mitral valve prolapse.. N Engl J Med 1986; 314: 577-578
  CrossrefPubMedGoogle Scholar
• 8 Perloff JK, Child JS, Edwards JE. New guidelines for the clinical diagnosis of mitral valve prolapse.. Am J Cardiol 1986; 57: 1124-1129
  CrossrefPubMedGoogle Scholar
• 9 Kriwisky M, Froom P, Gross M, Ribak J, Lewis BS. Usefulness of echocardiographically determined mitral leaflet motion for diagnosis of mitral valve prolapse in 17- and 18-year-old men.. Am J Cardiol 1987; 59: 1149-1151
  CrossrefPubMedGoogle Scholar
• 10 Markiewietz W, Stoner J, London E, Bunt SA, Popp RL. Mitral valve prolapse in 100 presumably healthy young females. Circulation 1976; 53: 464-473
  CrossrefPubMedGoogle Scholar
• 11 Mintz GS, Kotlev MN, Parry WR, Segal BE. Statistical comparison of M mode and two dimensional echocardiographie diagnosis of flail mitral leaflets.. Am J Cardiol 1980; 45: 253
  CrossrefPubMedGoogle Scholar
• 12 Grenadier E, Alpan G, Keidar S, Palant A. The prevalence of ruptured chordae tendineae in the mitral valve prolapse syndrome.. Am Heart J 1983; 105: 603-610
  CrossrefPubMedGoogle Scholar
• 13 Ness PM, Perkins HA. A simple enzyme immunoassay (EIA) test for Factor VUI-related antigen (VIII : Ag).. Thromb Haemostas 1979; 42: 848-854
  PubMedGoogle Scholar
• 14 Rapaport SI. Preoperative hemostatic evaluation: Which tests, if any?. Blood 1983; 61: 229-231
  PubMedGoogle Scholar
• 15 Zelis R. The contribution of local factors to the elevated venous tone of congestive heart failure.. JCI 1974; 54: 219-224
  CrossrefPubMedGoogle Scholar
• 16 Prentice CRM, Forbe CD, Smith SM. Rise of factor VIII after exercise and adrenaline infusion measured by immunological and biological techniques... Thromb Res 1972; 1: 493-506
  CrossrefPubMedGoogle Scholar