Chest
Volume 81, Issue 5, May 1982, Pages 620-625
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Analysis of QT Interval in Patients with Idiopathic Mitral Valve Prolapse

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Patient Selection

Two groups of subjects were included in this study. Croup 1 was composed of 56 patients (44 women and 12 men) with mitral valve prolapse, ranging in age from 18 to 73 years (mean, 46 ± 17 years). To limit this group to patients with IMVP, we excluded patients with Marian's syndrome, a history of rheumatic fever, and clinical or laboratory evidence of other valvular abnormalities, congenital cardiac defects, or cardiomyopathy. Referral to a cardiologist was primarily due to systolic clicks or

Results

The heart rate ranged from 39 to 105 per minute (mean, 74 ± 12) in group 1 and from 38 to 93 per minute (mean, 68 ± 12.5) in group 2.

After correction for age, the maximal QT interval of patients in group 1 exceeded the 97.5 percentile of Simonson and associates2 normal population in 51 patients (91 percent) and was at the upper limits of normal values in the remaining five patients. In the control subjects (group 2) the maximal QT interval exceeded the 97.5 percentile of the normal population

Discussion

Most postulated mechanisms for the arrhythmias associated with IMVP have been related to the mitral valve or left ventricular abnormalities.2,3,4,20,21 Abnormal mitral leaflet motion acting as a mechanical stimulus for generation of ectopic beats as suggested by some workers5 does not explain the intermittent nature of the arrhythmias. Wit and associates20 demonstrated muscle fibers in the mitral leaflet of dogs, which, when exposed to stretching or epinephrine, can initiate atrial arrhythmias.

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