Floppy mitral valve/mitral valve prolapse: A complex entity with multiple genotypes and phenotypes

Prog Cardiovasc Dis. 2020 May-Jun;63(3):308-326. doi: 10.1016/j.pcad.2020.03.004. Epub 2020 Mar 19.

Abstract

Floppy mitral valve/mitral valve prolapse (FMV/MVP) is a common valvular abnormality affecting 2% to 3% of the general population. It occurs in a heterogeneous group of patients with varying and age dependent expressions. FMV/MVP can be familial or sporadic, isolated (called non-syndromic) or as a part of a well-defined syndrome of heritable connective tissue disorders or other diseases. A wide range of phenotypic expression exists ranging from asymptomatic to non-specific symptoms related to neuroendocrine or autonomic nervous system functional abnormalities, varying degrees of mitral regurgitation that may require interventional therapy, heart failure, infective endocarditis, cardiac arrhythmias and/or sudden cardiac death. FMV/MVP is predominantly considered a heritable disorder with clinical manifestations not present at birth, but appearing later in life. Though a variant gene may initiate the development of FMV/MVP, precise phenotypic expression may be related to multiple other molecular, genetic and epigenetic factors that modify the final expression of the disease. A better understanding of these mechanisms will help to better define the natural history of the disease, inhibit disease progression and even prevent the phenotypic expression of FMV/MVP.

Keywords: Familial; Floppy mitral valve; Gene variants; Heritable; Mitral valve prolapse; Non-syndromic; Polymorphisms; Sporadic; Syndromic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Disease Progression
  • Genetic Predisposition to Disease
  • Heredity
  • Humans
  • Mitral Valve / abnormalities*
  • Mitral Valve / physiopathology
  • Mitral Valve Prolapse / epidemiology
  • Mitral Valve Prolapse / genetics*
  • Mitral Valve Prolapse / physiopathology
  • Mitral Valve Prolapse / therapy
  • Pedigree
  • Phenotype
  • Prevalence
  • Risk Factors