Anterior Mitral Valve Prolapse Contributes to Mitral Regurgitation and Panic Disorder

Yıl 2012, Cilt: 19 Sayı: 1, 19 - 22, 01.02.2012

Rifat Eralp Ulusoy Mehmet Yokuşoğlu Ata Kırılmaz Uğur Küçük Haşmet Işıklı

Öz

Objective: Mitral valve prolapse is affecting 2,4% of general population which shows similar prevalence, age and gender distribution and share common nonspecific symptoms with panic disorder. The aim of this prospective study is to investigate the contribution of the anterior mitral leaflet prolapse to mitral regurgitation and panic disorder. Material and Methods: Ninety-six patients, who were finally diagnosed as having non-cardiac chest pain with anterior mitral valve prolapse during the evaluation of chest pain, palpitation and fatigue were assessed for panic disorder. Results: From 96 patients with mitral valve prolapse (mean age 40±8 years), 46 (48%) had panic disorder and 32 (33%) had mitral regurgitation. Majority of the patients were female (53%). 48 % of the patients with panic disorder had mitral regurgitation. Among 32 patients with mitral regurgitation, 22 (69%) had panic disorder. The incidence of panic disorder in patients with mitral regurgitation was 69%. Among those with panic disorder, 48% had mitral regurgitation. There was a significant correlation between mitral regurgitation and panic disorder (p=0.004). Conclusion: This study has demonstrated the possible contribution of the anterior mitral leaflet prolapse to mitral regurgitation and panic disorder. Panic disorder and mitral valve prolapse presents a co-morbidity, which deserves further clinical investigations. Key words: Mitral Valve Prolapse; Panic Disorder; Mitral Regurgitation.

Anahtar Kelimeler

Mitral Valve Prolapse; Panic Disorder; Mitral Regurgitation.

Anteriyor Mitral Kapak Prolapsusu Mitral Yetersizlik ve Panik Bozukluğa Katkıda Bulunmaktadır

Öz

Amaç: Mitral kapak prolapsusu genel populasyonun %2.4'ünü etkilemektedir. Panik bozuklukla benzer sıklık, yaş ve cinsiyet dağılımı göstermekte ve ortak nonspesifik semptomları paylaşmaktadır. Bu prospektif çalışmada anteriyor mitral kapak prolapsusunun mitral yetersizlik ve panik bozukluğa katkısının araştırılması amaçlanmaktadır. Gereç ve Yöntemler: Göğüs ağrısı, çarpıntı ve halsizlik yakınması nedeniyle değerlendirlen ve sonuçta anteriyor mitral kapak prolapsusu ve non kardiyak göğüs ağrısı tanısı konulan 96 hasta panik bozukluk açısından araştırıldı. Bulgular: Mitral kapak prolapsusu olan 96 hastadan (ortalama yaş 40±8) 46'sında (%48) panik bozukluk ve 32'sinde (%33) mitral yetersizlik saptandı. Hastaların çoğunluğu (%53) kadındı ve mitral yetersizlikli 32 hastanın 22'sinde (%69) panik bozukluk vardı. Panik bozukluk saptanan hastaların %48'inde mitral yetersizlik saptandı. Mitral yetersizlikle panik bozukluk arasında istatistiksel olarak önemli korelasyon saptandı (p=0,004). Sonuç: Bu çalışmanın sonuçları anteriyor mitral kapak prolapsusunun mitral yetersizlik ve panik bozuklukla muhtemel birlikteliğini ortaya koymaktadır. Panik bozukluk ve mitral kapak prolapsusu birliktelik oluşturmakta ve bu durum daha geniş çaplı ileri çalışmalarla desteklenmelidir. Anahtar kelimeler: Mitral Kapak Prolapsusu; Panik Bozukluk; Mitral Yetersizliği.

Anahtar Kelimeler

Mitral Kapak Prolapsusu; Panik Bozukluk; Mitral Yetersizliği.

Kaynakça

• Alpert MA, Mukerji V, Sabeti M, Russell JL, Beitman BD. Mitral Valve Prolapse, Panic Disorder, and Chest Pain. Med Clin North Am 1991; 75(5): 1119-33.
• Sternbach G, Varon J. John Barlow: Mitral Valve Prolapse. J Emerg Med 1993; 11(4): 475-8. DOI: 10.1016/0736-4679(93)90252-3
• Nesta F, Leyne M, Yosefy C, et al. New Locus for Autosomal Dominant Mitral Valve Prolapse on Chromosome 13: Clinical Insights from Genetic Studies. Circulation 2005; 112(13): 2022-30. DOI: 10.1161/CIRCULATIONAHA.104.516930
• Freitag CM, Domschke K, Rothe C, et al. Interaction of Serotonergic and Noradrenergic Gene Variants in Panic Disorder. Psychiatr Genet 2006; 16(2): 59-65. DOI: 10.1097/01.ypg.0000199443.69668.b1
• Unschuld PG, Ising M, Erhardt A, et al. Polymorphisms in the Galanin Gene are Associated with Symptom- Severity in Female Patients Suffering from Panic Disorder. J Affect Disord 2008; 105(1-3): 177-84. DOI: 10.1016/j.jad.2007.05.006
• Andrade L, Eaton WW, Chilcoat HD. Lifetime Co- Morbidity of Panic Attacks and Major Depression in a Population-based Study: Age of Onset. Psychol Med 1996; 26(5): 991-6. DOI: 10.1017/S0033291700035315
• Gregory AM, Caspi A, Moffitt TE, Koenen K, Eley TC, Poulton R. Juvenile Mental Health Histories of Adults with Anxiety Disorders. Am J Psychiatry 2007; 164(2): 301-8. DOI: 10.1176/appi.ajp.164.2.301
• Keyl PM, Eaton WW. Risk Factors for the Onset of Panic Disorder and Other Panic Attacks in a Prospective, Population-Based Study. Am J Epidemiol 1990; 31(2): 301-11.
• Nardi AE, Valença AM, Mezzasalma MA, et al. Comparison Between Hyperventilation and Breath- Holding in Panic Disorder: Patients Responsive and Non- responsive to Both Tests. Psychiatry Res 2006; 142(2-3): 201-8. DOI: 10.1016/j.psychres.2005.07.032
• Liberthson R, Sheehan DV, King ME, Weyman AE. The Prevalence of Mitral Valve Prolapse in Patients with Panic Disorders. Am J Psychiatry 1986; 143(4): 511-5.
• Margraf J, Ehlers A, Roth WT. Mitral Valve Prolapse and Panic Disorder: A Review of Their Relationship. Psychosom Med 1988; 50(2): 93-113.
• Gorman JM, Shear MK, Devereux RB, King DL, Klein DF. Prevalence of Mitral Valve Prolapse in Panic Disorder: Effect of Echocardiographic Criteria. Psychosom Med 1986; 48(3-4): 167-71.
• Pariser SF, Pinta ER, Jones BA. Mitral Valve Prolapse Syndrome and Anxiety Neurosis/Panic Disorder. Am J Psychiatry 1978; 135(2): 246-7.
• Jesse RL, Kontos MC. Evaluation of Chest Pain in the Emergency Department. Curr Probl Cardiol 1997; 22(4): 149-236. DOI: 10.1016/S0146-2806(97)80007-2
• Tamam L, Ozpoyraz N, San M, Bozkurt A. Association Between Idiopathic Mitral Valve Prolapse and Panic Disorder. Croat Med J 2000; 41(4): 410-6.
• Coplan JD, Papp LA, King DL, Gorman JM. Amelioration of Mitral Valve Prolapse After Treatment for Panic Disorder. Am J Psychiatry 1992; 149(11): 1587- 8.
• Matuzas W, Al-Sadir J, Uhlenhuth EH, Glass RM, Easton C. Correlates of Mitral Valve Prolapse Among Patients with Panic Disorder. Psychiatry Res 1989 28(2): 161-70. DOI: 10.1016/0165-1781(89)90044-9
• Bowen RC, D'Arcy C, Orchard RC. The Prevalence of Anxiety Disorders Among Patients with Mitral Valve Prolapse Syndrome and Chest Pain. Psychosomatics 1991; 32(4): 400-6. DOI: 10.1016/S0033-3182(91)72041-0
• Katerndahl DA. Panic and Prolapse. Meta-analysis. J Nerv Ment Dis 1993; 181(9): 539-44. DOI: 10.1097/00005053- 199309000-00002
• Sivaramakrishnan K, Alexander PJ, Saharsarnamam N. Prevalence of Panic Disorder in Mitral Valve Prolapse: a Comparative Study with a Cardiac Control Group. Acta Psychiatr Scand 1994; 89(1): 59-61. DOI: 10.1111/j.1600- 0447.1994.tb01486.x
• Toren P, Eldar S, Cendorf D, et al. The Prevalence of Mitral Valve Prolapse in Children with Anxiety Disorders. J Psychiatr Res 1999; 33(4): 357-61. DOI: 10.1016/S0022- 3956(99)00005-9
• Yang S, Tsai TH, Hou ZY, Chen CY, Sim CB. The Effect of Panic Attack on Mitral Valve Prolapse. Acta Psychiatr Scand 1997; 96(6): 408-11. DOI: 10.1111/j.1600- 0447.1997.tb09940.x
• How to cite this article: Ulusoy RE, Yokuşoğlu
• M, Kırılmaz A, Küçük U, Işıklı H. Anterior Mitral
• Valve Prolapse Contributes to Mitral Regurgitation
• and Panic Disorder. JIUMF 2012; 19(1): 19-22.
• DOI: 10.7247/jiumf.2012.19.1.19_22