How to manage an athlete with mitral valve prolapse

23 October 2019
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References

Further reading:

[1] Delling FN, Vasan RS. Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis. Circulation. 2014;129(21):2158-70.

[2] Carpentier A. Cardiac valve surgery--the "French correction". J Thorac Cardiovasc Surg. 1983;86(3):323-37.

[3] Anyanwu AC, Adams DH. Etiologic classification of degenerative mitral valve disease: Barlow's disease and fibroelastic deficiency. Semin Thorac Cardiovasc Surg. 2007;19(2):90-6.

[4] Syed FF, Ackerman MJ, McLeod CJ, Kapa S, Mulpuru SK, Sriram CS, Cannon BC, Asirvatham SJ, Noseworthy PA. Sites of Successful Ventricular Fibrillation Ablation in Bileaflet Mitral Valve Prolapse Syndrome. Circ Arrhythm Electrophysiol. 2016;9(5). pii: e004005. doi: 10.1161/CIRCEP.116.004005.

[5] Monin JL, Dehant P, Roiron C, Monchi M, Tabet JY, Clerc P, Fernandez G, Houel R, Garot J, Chauvel C, Gueret P. Functional assessment of mitral regurgitation by transthoracic echocardiography using standardized imaging planes diagnostic accuracy and outcome implications. J Am Coll Cardiol. 2005;46(2):302-9.

[6] Carbone A, D'Andrea A, Scognamiglio G, Scarafile R, Tocci G, Sperlongano S, Martone F, Radmilovic J, D'Amato M, Liccardo B, Scherillo M, Galderisi M, Golino P. Mitral Prolapse: An Old Mysterious Entity - The Incremental Role of Multimodality Imaging in Sports Eligibility. J Cardiovasc Echogr. 2018;28(4):207-217. doi: 10.4103/jcecho.jcecho_42_18.

[7] Gati S, Malhotra A, Sharma S. Exercise recommendations in patients with valvular heart disease. Heart. 2019;105(2):106-110. doi: 10.1136/heartjnl-2018-313372.

[8] Perazzolo Marra M, Basso C, De Lazzari M, Rizzo S, Cipriani A, Giorgi B, Lacognata C, Rigato I, Migliore F, Pilichou K, Cacciavillani L, Bertaglia E, Frigo AC, Bauce B, Corrado D, Thiene G, Iliceto S. Morphofunctional Abnormalities of Mitral Annulus and Arrhythmic Mitral Valve Prolapse. Circ Cardiovasc Imaging. 2016;9(8):e005030. doi: 10.1161/CIRCIMAGING.116.005030.

[9] Basso C, Iliceto S, Thiene G, Perazzolo Marra M. Mitral Valve Prolapse, Ventricular Arrhythmias, and Sudden Death. Circulation. 2019;140(11):952-964.

[10] Kitkungvan D, Nabi F, Kim RJ, Bonow RO, Khan MA, Xu J, Little SH, Quinones MA, Lawrie GM, Zoghbi WA, Shah DJ. Myocardial Fibrosis in Patients With Primary Mitral Regurgitation With and Without Prolapse. J Am Coll Cardiol. 2018;72(8):823-834. doi: 10.1016/j.jacc.2018.06.048.

[11] Miller MA, Dukkipati SR, Turagam M, Liao SL, Adams DH, Reddy VY. Arrhythmic Mitral Valve Prolapse: JACC Review Topic of the Week. J Am Coll Cardiol. 2018;72(23 Pt A):2904-2914. doi: 10.1016/j.jacc.2018.09.048.

[12] Basso C, Perazzolo Marra M, Rizzo S, De Lazzari M, Giorgi B, Cipriani A, Frigo AC, Rigato I, Migliore F, Pilichou K, Bertaglia E, Cacciavillani L, Bauce B, Corrado D, Thiene G, Iliceto S. Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death. Circulation. 2015;132(7):556-66. doi: 10.1161/CIRCULATIONAHA.115.016291.

[13] Caselli S, Mango F, Clark J, Pandian NG, Corrado D, Autore C, Pelliccia A. Prevalence and Clinical Outcome of Athletes With Mitral Valve Prolapse. Circulation. 2018;137(19):2080-2082.

[14] Muthukumar L, Rahman F, Jan MF, Shaikh A, Kalvin L, Dhala A, Jahangir A, Tajik AJ. The Pickelhaube Sign: Novel Echocardiographic Risk Marker for Malignant Mitral Valve Prolapse Syndrome. JACC Cardiovasc Imaging. 2017;10(9):1078-1080. doi: 10.1016/j.jcmg.2016.09.016.

[15] Bonow RO, Nishimura RA, Thompson PD, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 5: valvular heart disease: a scientific statement From the American Heart Association and American College of Cardiology. Circulation 2015;132:e292–7.

[16] Pelliccia A, Fagard R, Bjørnstad HH, Anastassakis A, Arbustini E, Assanelli D, Biffi A, Borjesson M, Carrè F, Corrado D, Delise P, Dorwarth U, Hirth A, Heidbuchel H, Hoffmann E, Mellwig KP, Panhuyzen-Goedkoop N, Pisani A, Solberg EE, van-Buuren F, Vanhees L, Blomstrom-Lundqvist C, Deligiannis A, Dugmore D, Glikson M, Hoff PI, Hoffmann A, Hoffmann E, Horstkotte D, Nordrehaug JE, Oudhof J, McKenna WJ, Penco M, Priori S, Reybrouck T, Senden J, Spataro A, Thiene G; Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology; Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2005;26(14):1422-45.

[17] Adams DH, Rosenhek R, Falk V. Degenerative mitral valve regurgitation: best practice revolution. Eur Heart J. 2010;31(16):1958-66. doi:10.1093/eurheartj/ehq222.

[18] Cheng DC, Martin J, Lal A, Diegeler A, Folliguet TA, Nifong LW, Perier P, Raanani E, Smith JM, Seeburger J, Falk V. Minimally invasive versus conventional open mitral valve surgery: a meta-analysis and systematic review. Innovations (Phila). 2011;6(2):84-103.

[19] Salvador L, Mirone S, Bianchini R, Regesta T, Patelli F, Minniti G, Masat M, Cavarretta E, Valfrè C. A 20-year experience with mitral valve repair with artificial chordae in 608 patients. J Thorac Cardiovasc Surg. 2008;135(6):1280-7. doi: 10.1016/j.jtcvs.2007.12.026.

Notes to editor

Authors information:

  • Dr. Elena Cavarretta1,2
  • Dr. Mariangela Peruzzi1,2
  • Dr. Luigi Sciarra3


1- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
2 - Mediterranea Cardiocentro, Naples, Italy
3 - Policlinico Casilino, Rome, Italy

Contributors