Echocardiographically Documented Mitral-Valve Prolapse: Long-Term Follow-up of 237 Patients

Rick A. Nishimura, Michael D. McGoon, Clarence Shub, Fletcher A. Miller, Duane M. Ilstrup, A. Jamil Tajik

Research output: Contribution to journalArticlepeer-review

385 Scopus citations


We determined the long-term prognosis for patients with mitral-valve prolapse documented by echocardiography by following 237 minimally symptomatic or asymptomatic patients for a mean of 6.2 years (range, 1 to 10.4). The actuarial eight-year probability of survival was 88 per cent, which is not significantly different from that for a matched control population. An initial left ventricular diastolic dimension exceeding 60 mm was the best echocardiographic predictor of the subsequent need for mitral-valve replacement (17 patients). Of the 97 patients with redundant mitral-valve leaflets identified echocardiographically, 10 (10.3 per cent) had sudden death, infective endocarditis, or a cerebral embolic event; in contrast, of the 140 patients with nonredundant valves, only 1 (0.7 per cent) had such complications (P<0.001). Most patients with echocardiographic evidence of mitral-valve prolapse have a benign course, but subsets at high risk for the development of progressive mitral regurgitation, sudden death, cerebral embolic events, or infective endocarditis can be identified by echocardiography. (N Engl J Med 1985; 313:1305–9.).

Original languageEnglish (US)
Pages (from-to)1305-1309
Number of pages5
JournalNew England Journal of Medicine
Issue number21
StatePublished - Nov 21 1985

ASJC Scopus subject areas

  • Medicine(all)


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