Echocardiographic and Pathophysiologic Insights into Mitral Regurgitation, Mitral Annular Disjunction, and Ventricular Arrhythmias in Patients with Mitral Valve Prolapse.

Mitral valve prolapse (MVP) affects approximately 2.5% of the population and represents the most common cause of primary mitral regurgitation. Mitral regurgitation is related to increased leaflet size, prolapse asymmetry, long clefts, calcification, and restricted leaflet motion. Chordal abnormalities, including increased length and rupture, also play a role. MVP is also recognized as an important cause of ventricular arrhythmias and sudden arrhythmic death. Patients with arrhythmic MVP commonly exhibit an echocardiographic phenotype characterized by thick, long mitral leaflets with multi-segment bi-leaflet prolapse and mitral annular disjunction, with or without significant MR. This review discusses the pathophysiology and echocardiographic findings of these abnormalities.