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Mitral Valve Prolapse, Psychoemotional Status, and Quality of Life: Prospective Investigation in the Current Era - 25/09/16

Doi : 10.1016/j.amjmed.2016.05.004 
Tali Bayer-Topilsky, PhD a, b, Rakesh M. Suri, MD, PhD c, Yan Topilsky, MD d, Yariv N. Marmor, PhD e, Max R. Trenerry, PhD f, Ryan M. Antiel, MD, PhD g, Douglas W. Mahoney, MS h, Hartzell V. Schaff, MD g, Maurice Enriquez-Sarano, MD a,
a Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 
b The Engelberg Center for Children and Youth, JDC-Myers-Brookdale Institution, Jerusalem, Israel 
c Thoracic & Cardiovascular Surgery at Cleveland Clinic, Abu Dhabi, United Arab Emirates 
d Department of Cardiology, Sourasky Medical Center, Tel Aviv, Israel 
e Department of Industrial Engineering and Management, ORT Braude College of Engineering, Karmiel, Israel 
f Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn 
g Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn 
h Section of Biostatistics, Mayo Clinic, Rochester, Minn 

Requests for reprints should be addressed to Maurice Enriquez-Sarano, MD, Mayo Clinic, Mayo College of Medicine, 200 First Street SW, Rochester, MN 55901.Mayo ClinicMayo College of Medicine200 First Street SWRochesterMN55901

Abstract

Objective

The purpose of this study is to investigate whether mitral valve prolapse is associated with the patient's psychoemotional status and health-related quality of life.

Methods

Mitral valve prolapse and mitral regurgitation were prospectively and comprehensively assessed in 281 patients (age 61 ± 13 years; 63% men); 216 patients with mitral valve prolapse were compared with 65 without mitral valve prolapse (of similar age and sex). Simultaneously, we assessed the patient's psychoemotional status (anxiety, depression, posttraumatic stress symptoms), health-related quality of life, and perceived severity of illness using validated questionnaires.

Results

Twenty-nine percent of the patients had either no or mild mitral regurgitation (area of effective regurgitant orifice ≤0.2), and 71% had clinically significant mitral regurgitation (moderate/severe). Stratifying patients into no/mild vs moderate/severe mitral regurgitation revealed no differences in psychoemotional status or mental health-related quality of life between patients with mitral valve prolapse vs those without mitral valve prolapse within each subgroup; no/mild mitral regurgitation and moderate/severe mitral regurgitation (all P ≥ .5). In multivariate analysis, mitral valve prolapse was not independently associated with psychoemotional status or health-related quality of life (all P ≥ .4). In addition, while objective severity of the illness was not related to psychoemotional status or health-related quality of life (all P ≥ .2), the patient's perceived severity of illness predicted in and of itself all psychoemotional (all P < .03) and quality-of-life outcomes (all P < .003).

Conclusion

Mitral valve prolapse is not a determinant of the patient's psychoemotional status or quality of life. Psychoemotional status and health-related quality of life are determined by the patient's perception of the severity of the mitral valve disease, rather than by the presence of mitral valve prolapse.

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Keywords : Patient care, Symptoms, Valve disease, Well-being


Esquema


 Funding: None.
 Conflict of Interest: None.
 Authorship: All authors meet the criteria for authorship and have contributed to the concept of the study, data collection, data analysis and interpretation, and drafting or revision of the manuscript.


© 2016  Elsevier Inc. Reservados todos los derechos.
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Vol 129 - N° 10

P. 1100-1109 - octobre 2016 Regresar al número
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