Association between Body Mass Index and Mitral Valve Prolapse

Document Type : Original Article

Authors

1 General Practitioner, School of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran

2 Cardiologist, Department of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran

3 Medical Student, Student Research Committee, Sabzevar University of Medical Sciences, Medical faculty, Sabzevar, Ira

Abstract

Introduction: Body mass index (BMI) can affect cardiac morphology; however, the relationship between BMI and valvular heart diseases has not been thoroughly evaluated. This study aimed to determine the relationship between BMI and mitral valve prolapse (MVP) as one of the most common valve diseases worldwide. It can help us to better understand pathophysiology of this common disease.
Materials and Methods: In this descriptive study we enrolled 200 patients with isolated MVP. This patient was referred from 2014 to 2015 to our cardiology clinic in Mashhad, Iran, with chief complaint of chest pain, dyspnea, and palpitation. patients underwent transthoracic echocardiography. We document the patients’ height, weight, and demographics data. BMI distribution was categorized as higher and lower than 18.5 kg/m2. Chi- square and independent samples t-test were performed using SPSS version 19 to analyze the data.
Results: The results showed that 92 (46%) and 108 (54%) of the samples were male and female, respectively, and their mean age was 24.29±3.75 years. Most of the patients(n=110) had low BMI (55% of the patients had BMI lower than 18.5 kg/m2). Left atrial and ventricular diameters had a significant relationship with BMI of all the underweight patients(n=110) (P=0.026 and 0.032, respectively). The main complaints were chest pain (n=55,50%) and dyspnea (n=58,64.44%) in the patients with low and normal BMI, respectively.
Conclusion: Symptoms and echocardiographic features in MVP patients vary with BMI. While mitral valve annulus diameter was the same in both BMI groups, the results showed that left atrial and ventricular diameters in the underweight patients were less than those with normal BMI.

Keywords


1.Zheng XY, Han YL, Guo C, Zhang L, Qiu Y, Chen G. Progress in research of nutrition and life expectancy. Biomed Environ Sci. 2014; 27:155-61.
2. Sokmen A, Sokmen G, Acar G, Akcay A, Koroglu S, Koleoglu M, et al. The impact of isolated obesity on right ventricular function in young adults. Arq Bras Cardiol. 2013; 101:160-8.
3. Freed LA, Benjamin EJ, Levy D, Larson MG, Evans JC, Fuller DL, et al. Mitral valve prolapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol. 2002; 40:1298-304.
4. Freed LA, Levy D, Levine RA, Larson MG, Evans JC, Fuller DL, et al. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med. 1999; 341:1-7.
5. Han Y, Peters DC, Kissinger KV, Goddu B, Yeon SB, Manning WJ, et al. Evaluation of papillary muscle function using cardiovascular magnetic resonance imaging in mitral valve prolapse. Am J Cardiol. 2010; 106:243-8.
6. Janghorbani M, Amini M, Willett WC, Gouya MM, Delavari A, Alikhani S, et al. First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity. 2007; 15:2797-808.
7. Movahed MR, Hepner AD. Mitral valvar prolapse is significantly associated with low body mass index in addition to mitral and tricuspid regurgitation. Cardiol Young. 2007; 17:172-4.
8. Theal M, Sleik K, Anand S, Yi Q, Yusuf S, Lonn E. Prevalence of mitral valve prolapse in ethnic groups. Can J Cardiol. 2004; 20:511-5.
9. Gabbay U, Yosefy C. The underlying causes of chordae tendinae rupture: a systematic review. Int J Cardiol. 2010; 143:113-8.
10. Delling FN, Vasan RS. Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis. Circulation. 2014; 129:2158-70
11. Van Der Ham DP, De Vries JK, Van Der Merwe PL. Mitral valve prolapse: a study of 45 children. Cardiovasc J S Afr. 2003; 14:191-4.
12. Kumar PV, Mundi A, Caldito G, Reddy PC. Higher body mass index is an independent predictor of left atrial enlargement. Int J Clin Med. 2011; 2:556.
13. Yiginer O, Keser N, Ozmen N, Tokatli A, Kardesoglu E, Isilak Z, et al. Classic mitral valve prolapse causes enlargement in left ventricle even in the absence of significant mitral regurgitation. Echocardiography. 2012; 29:123-9.
14. Gottdiener JS, Reda DJ, Williams DW, Materson BJ. Left atrial size in hypertensive men: influence of obesity, race and age. Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. J Am Coll Cardiol. 1997; 29:651-8.