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Mitral valve prolapse (MVP) is a frequent affection of the mitral valve with a prevalence of 2-3% in the general population. This valvular disease is generally considered as benign, but may at term evolve toward mitral valve regurgitation of various severity and/or arrhythmia.
Mitral valve prolapse is routinely diagnosed using transthoracic echocardiography. Subsequent examinations (24-hour external loop recording, exercise electrocardiogram, cardiac Magnetic Resonance Imaging) and a close follow-up can be proposed to the patient depending on its condition.
More recently, detection of myocardial fibrosis and a mitral ring disjunction among patients with MVP were associated with the occurrence of severe ventricular arrhythmia.
The investigators hypothesize that ventricular remodeling over time is mediated by the progression of mitral insufficiency severity from myocardial fibrosis secondary to MVP and possibly promoted by other mitral valve abnormalities. This remodeling, characterized by circulating biomarkers and imaging (MRI and echocardiography), could allow the identification of patients with a higher risk of severe ventricular arrhythmia.
The main objective of this study is to identify prognostic factors for unfavorable evolution (ventricular remodeling or a rhythm disorder event) at 3 years from initial assessments in MVP patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A (a) : patients without mitral regurgitation without ventricular extrasystole (≤10/hour) | Experimental | These patients will undergo at the inclusion and 36 months after the inclusion :
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| Group A (b) : patients without mitral regurgitation with ventricular extrasystole (>10/hour) | Experimental | These patients will undergo at the inclusion and 36 months after the inclusion :
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| Group B : patients with Mitral valve prolapse with trivial mitral regurgitation | Experimental | These patients will undergo at the inclusion and 36 months after the inclusion :
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| Group C : patients with Mitral valve prolapse with moderate or mild mitral regurgitation | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cardiac MRI | Procedure | Injected cardiac MRI |
|
| Measure | Description | Time Frame |
|---|---|---|
| Presence of ventricular remodelling | Variation of at least 10% of the telestolic volume observed at 3 years on cardiac MRI compared to the initial cardiac MRI | 3 years |
| Presence of ventricular arrythmia (fibrillation or tachycardia, extrasystoles) | Occurrence of any ventricular arrythmia on external loop recording or exercise ECG | 3 years |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nancy University Hospital | Vandœuvre-lès-Nancy | 54511 | France |
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| ID | Term |
|---|---|
| D008945 | Mitral Valve Prolapse |
| ID | Term |
|---|---|
| D016127 | Heart Valve Prolapse |
| D006349 | Heart Valve Diseases |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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These patients will undergo at the inclusion and 36 months after the inclusion :
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| Group D : patients with asymptomatic Mitral valve prolapse with severe mitral regurgitation | Experimental | These patients will undergo at the inclusion and 36 months after the inclusion :
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| Blood collection | Other | Blood collection (including genetics at the inclusion visit) |
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| Prolongation of the MRI examination | Procedure | Prolongation of the MRI examination (4D flow sequence ; about 10 min) |
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| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |