Cerebral Ischemia and Mitral Valve Prolapse: Case-Control Study of Associated Factors

We evaluated 36 patients with cerebral ischemia and mitral valve prolapse and compared them with 36 age-matched controls with cerebral ischemia who had similar attributes but who did not have mitral valve prolapse. Stepwise logistic regression analysis revealed an inverse relation between cerebral ischemia in the presence of mitral valve prolapse and hypertension, diabetes mellitus, occlusive cerebrovascular disease, and completed stroke at p<0.01. We also found, by correlation analysis, a negative correlation between both hypertension and diabetes mellitus versus mitral valve prolapse at p<0.05. Overall, 10 study patients compared with two control patients had no risk factors for cerebrovascular disease detected (x2 = 4.9, p<0.05). These data indicate that the association of mitral valve prolapse and cerebral ischemia is of special importance in patients who do not have other detected risk factors for cerebrovascular disease. (Stroke 1988; 19:443—446) There continues to be considerable controversyabout the exact role of mitral valve prolapse(MVP) in cerebral ischemia (CI). The numer-ous reports suggesting an association1"4 have been influenced by patient selection and possible referral bias. One would expect, for example, that with a 2.5-7 % prevalence of MVP in the general population5"