Classic and non-classic forms of mitral valve prolapse.

OBJECTIVE: To investigate the significance of the established distinction between classic and non-classic forms of mitral valve prolapsed (MVP). METHODS: We included in this prospective study all patients examined in our preventive cardiology outpatient clinics during the biannual period October 2004-October 2006. We examined in total 10.818 patients, 238 of whom (2.2%) were diagnosed for MVP. We noted relevant demographic and clinical data (gender, age of diagnosis, symptoms, need for hospitalization) and performed statistical comparisons between patients with the classic and those with the non-classic form. Follow-up controls were performed three years afterwards. RESULTS: Patients with the classic form had an earlier age of first diagnosis, more prominent symptoms, and more frequently diagnosis for other disorders (atrial septal defect, ventricular septal defect, Marfan syndrome, Ehlers-Danlos syndrome) than the rest of the patients; however, there were no significant differences as far as certain major complications (stroke, death, submission to surgery) were concerned. CONCLUSION: The classic form of mitral valve prolapse is more tightly associated with morbid complications, and a more frequent follow-up control in this group of patients may be useful.

Dopexamine after heart surgery: an uncommonly used, though useful inotropic agent.

A great variety of inotropic agents with different effects on peripheral vascular resistance have been employed in the endeavor to treat heart failure after cardiac surgery. Epinephrine, norepinephrine, dopamine and dobutamine belong to the first-line, widely used drugs recruited to support and improve ventricular performance, although none of these agents can be described as the one having the most beneficial results with the least possible side effects. Herein, we are presenting thorough a thorough review of literature with patents on dopexamine, a useful, although not widely used inotropic agent, which also reduces peripheral vascular resistance and has beneficial effects on splachnic blood flow when administered after heart surgery.