{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:54:35Z","timestamp":1792086875616,"version":"4.4.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The prevalence of mitral valve prolapse (MVP) varies across populations and age groups; its natural history and clinical outcomes remain unclear. This meta-analysis established the prevalence of MVP in the general population, in associated syndromes and at different ages. It also determined the rate of progression and the incidence of adverse outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A systematic search identified original reports on the prevalence of MVP and related outcomes. A total of 83 studies met inclusion: 47 (n\u00a0=\u00a0992\u2009944) non-syndrome associated; 31 (n\u00a0=\u00a03067) syndrome associated; and 5 (n\u00a0=\u00a01287) described mitral regurgitation (MR) progression or adverse outcomes. In the general population, the prevalence was 1.35% but higher in hospital cohorts (8.7%). Age-stratified prevalence was 0.5, 1.8, 2.7, and 2.0% in neonates, children, adolescents and adults, respectively. Meta-regression and subgroup analysis found no significant difference (P\u00a0=\u00a00.81) across ages but revealed a significantly higher prevalence in older compared to young adults (2.87%\u00a0vs. 0.67%, P\u00a0=\u00a00.01). Prevalence rates were markedly higher in patients with genetic syndromes. MR progressed at 5.5 per 100 person-years, overall. Event rates for all-cause mortality, development of heart failure, and need for mitral valve intervention were 1.7, 1.0, and 1.2 per 100 person-years, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>MVP is common, with greater prevalence in syndromes. Although more common with age, MVP is observed in infants. MVP related MR is progressive, especially in moderate MR, and there is a signal of excess mortality for unclear reasons. Valve services must manage the whole life journey and the potential risks associated with MVP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcaf016","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T22:53:07Z","timestamp":1743288787000},"page":"631-641","source":"Crossref","is-referenced-by-count":15,"title":["Prevalence, progression, and clinical outcomes of mitral valve prolapse: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8978-8511","authenticated-orcid":false,"given":"Thalia","family":"Melamed","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Dentistry, Queen Mary University of London , Garrod Building, Turner St, London E1 2AD ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sveeta","family":"Badiani","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew's Hospital , London EC1A 7BE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Harlow","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Queen Mary University of London , Garrod Building, Turner St, London E1 2AD ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Laskar","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew's Hospital , London EC1A 7BE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1560-7414","authenticated-orcid":false,"given":"Thomas A","family":"Treibel","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew's Hospital , London EC1A 7BE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nay","family":"Aung","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew's Hospital , London EC1A 7BE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew's Hospital , London EC1A 7BE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew's Hospital , London EC1A 7BE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"2025081218290444900_bib1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1056\/NEJM199907013410101","article-title":"Prevalence and clinical outcome of mitral-valve prolapse","volume":"134","author":"Freed","year":"1999","journal-title":"N Eng J Med"},{"key":"2025081218290444900_bib2","doi-asserted-by":"publisher","first-page":"2158","DOI":"10.1161\/CIRCULATIONAHA.113.006702","article-title":"Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis","volume":"129","author":"Delling","year":"2014","journal-title":"Circulation"},{"key":"2025081218290444900_bib3","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1016\/s0735-1097(85)80021-8","article-title":"Prevalence of mitral valve prolapse in normal children","volume":"5","author":"Warth","year":"1985","journal-title":"J Am Coll Cardiol"},{"key":"2025081218290444900_bib4","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1161\/01.CIR.75.4.756","article-title":"The relationship of mitral annular shape to the diagnosis of mitral valve prolapse","volume":"75","author":"Levine","year":"1987","journal-title":"Circulation"},{"key":"2025081218290444900_bib5","doi-asserted-by":"publisher","first-page":"e6160","DOI":"10.3390\/jcm13206160","article-title":"Echocardiographic assessment of mitral valve prolapse prevalence before and after the year 1999: a systematic review","volume":"13","author":"Sonaglioni","year":"2024","journal-title":"J Clin Med"},{"key":"2025081218290444900_bib6","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.1161\/CIRCULATIONAHA.115.020621","article-title":"Evolution of mitral valve prolapse: insights from the Framingham heart study","volume":"133","author":"Delling","year":"2016","journal-title":"Circulation"},{"key":"2025081218290444900_bib7","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/s0002-9343(01)00981-0","article-title":"Prevalence and correlates of mitral valve prolapse in a population-based sample of American Indians: the strong heart study","volume":"111","author":"Devereux","year":"2001","journal-title":"Am J Med"},{"key":"2025081218290444900_bib8","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/s0002-8703(99)70151-1","article-title":"Anthropometric and physiologic correlates of mitral valve prolapse in a biethnic cohort of young adults: the CARDIA study","volume":"138","author":"Flack","year":"1999","journal-title":"Am Heart J"},{"key":"2025081218290444900_bib9","doi-asserted-by":"publisher","first-page":"e2719","DOI":"10.1038\/s41598-021-81648-z","article-title":"Prevalence and characteristics of mitral valve prolapse in military young adults in Taiwan of the CHIEF Heart Study","volume":"11","author":"Liu","year":"2021","journal-title":"Sci Rep"},{"key":"2025081218290444900_bib10","first-page":"2208","article-title":"The prevalence and clinical characteristics of mitral valve prolapse in a large population-based epidemiologic study: the MELEN study","volume":"19","author":"Turker","year":"2015","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025081218290444900_bib11","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1111\/j.1442-200x.1991.tb02573","article-title":"Mitral valve prolapse in childhood: the incidence and clinical presentations in different age groups","volume":"33","author":"Ohara","year":"1991","journal-title":"Acta Paediatr Jpn"},{"key":"2025081218290444900_bib12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.jjcc.2014.11.011","article-title":"Echocardiographic screening for congenital heart disease in 8819 children: a report from local community events for children's healthcare","volume-title":"J Cardiol","author":"Nishio","year":"2015"},{"key":"2025081218290444900_bib13","doi-asserted-by":"publisher","first-page":"e5982","DOI":"10.3390\/jcm11205982","article-title":"Echocardiographic abnormalities in autosomal dominant polycystic kidney disease (ADPKD) patients","volume":"11","author":"Pfeferman","year":"2022","journal-title":"J Clin Med"},{"key":"2025081218290444900_bib14","doi-asserted-by":"publisher","first-page":"1077788","DOI":"10.3389\/fcvm.2023.1077788","article-title":"Genetics and pathophysiology of mitral valve prolapse","volume":"10","author":"Delwarde","year":"2023","journal-title":"Front Cardiovasc med"},{"key":"2025081218290444900_bib15","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/0735-1097(88)90164-7","article-title":"Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study","volume":"11","author":"Duren","year":"1988","journal-title":"J Am Coll Cardiol."},{"key":"2025081218290444900_bib16","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1056\/NEJM198511213132101","article-title":"Echocardiographically documented mitral-valve prolapse. Long-term follow up of 237 patients","volume":"313","author":"Nishimura","year":"1985","journal-title":"N Eng J Med"},{"key":"2025081218290444900_bib17","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/s0002-8703(96)90432-9","article-title":"Relation between severity of mitral regurgitation and prognosis of mitral valve prolapse: echocardiographic follow-up study","volume":"132","author":"Kim","year":"1996","journal-title":"Am Heart J"},{"key":"2025081218290444900_bib18","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.amjcard.2007.10.029","article-title":"Risk, determinants, and outcome implications of progression of mitral regurgitation after diagnosis of mitral valve prolapse in a single community","volume":"101","author":"Aviernos","year":"2008","journal-title":"Am J Cardiol"},{"key":"2025081218290444900_bib19","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1161\/01.cir.0000028933.34260.09","article-title":"Natural history of asymptomatic mitral valve prolapse in the community","volume":"106","author":"Aviernos","year":"2002","journal-title":"Circulation"},{"key":"2025081218290444900_bib20","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1136\/heartjnl-2017-312932","article-title":"Mitral valve prolapse and sudden cardiac death: a systematic review and meta-analysis","volume":"105","author":"Nalliah","year":"2019","journal-title":"Heart"},{"key":"2025081218290444900_bib21","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting","volume":"283","author":"Stroup","year":"2000","journal-title":"J Am Med Assoc"},{"key":"2025081218290444900_bib22","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2025081218290444900_bib23","doi-asserted-by":"publisher","first-page":"e005030","DOI":"10.1161\/CIRCIMAGING.116.005030","article-title":"Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse","volume":"9","author":"Perazzolo Marra","year":"2016","journal-title":"Circ Cardiovasc Imaging"},{"key":"2025081218290444900_bib24","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-24-01","article-title":"Chapter 5: systematic reviews of prevalence and incidence","author":"Munn","year":"2020","journal-title":"JBI Manual for Evidence Synthesis"},{"key":"2025081218290444900_bib25","doi-asserted-by":"publisher","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann Intern Med"},{"key":"2025081218290444900_bib26","doi-asserted-by":"publisher","first-page":"e824","DOI":"10.1016\/j.wneu.2019.01.177","article-title":"Incidence and risk factors of cardiac abnormalities in patients with idiopathic scoliosis","volume":"125","author":"Lang","year":"2019","journal-title":"World Neurosurg"},{"key":"2025081218290444900_bib27","doi-asserted-by":"publisher","first-page":"226","DOI":"10.4184\/asj.2016.10.2.226","article-title":"A retrospective study of congenital cardiac abnormality associated with scoliosis","volume":"10","author":"Bozcali","year":"2016","journal-title":"Asian Spine J"},{"key":"2025081218290444900_bib28","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s002469900220","article-title":"Incidence and risk factors for mitral valve prolapse in severe adolescent idiopathic scoliosis","volume":"18","author":"Dhuper","year":"1997","journal-title":"Pediatr Cardiol"},{"key":"2025081218290444900_bib29","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1007\/s00467-022-05500-w","article-title":"Prevalence of cardiac valvar abnormalities in children and young people with autosomal dominant polycystic kidney disease","volume":"38","author":"Savis","year":"2023","journal-title":"Pediatr Nephrol"},{"key":"2025081218290444900_bib30","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1681\/ASN.V5122032","article-title":"Cardiovascular abnormalities in children with autosomal dominant polycystic kidney disease","volume":"5","author":"Ivy","year":"1995","journal-title":"J Am Soc Nephrol"},{"key":"2025081218290444900_bib31","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1056\/NEJM198810063191404","article-title":"Echocardiographic findings in autosomal dominant polycystic kidney disease","volume":"319","author":"Hossack","year":"1988","journal-title":"N Eng J Med"},{"key":"2025081218290444900_bib32","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.1093\/ehjqcco\/qcaa053","article-title":"Racial differences in the aetiology of mitral valve disease","volume":"7","author":"Hayward","year":"2021","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2025081218290444900_bib33","first-page":"511","article-title":"Prevalence of mitral valve prolapse in ethnic groups","volume":"20","author":"Theal","year":"2004","journal-title":"Can J Cardiol"},{"key":"2025081218290444900_bib34","doi-asserted-by":"publisher","first-page":"e020919","DOI":"10.1161\/JAHA.121.020919","article-title":"Mitral valve prolapse and its motley crew-syndromic prevalence, pathophysiology, and progression of a common heart condition","volume":"10","author":"Morningstar","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2025081218290444900_bib35","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.1161\/CIRCULATIONAHA.112.000064","article-title":"Cardiovascular disease in Williams Syndrome","volume":"127","author":"Collins","year":"2013","journal-title":"Circulation"},{"key":"2025081218290444900_bib36","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1007\/s10554-020-02150-7","article-title":"Echocardiographic screening for mitral valve prolapse in Turkish school children","volume":"37","author":"\u00c7a\u011flayan","year":"2021","journal-title":"Int J Cardiovas Imaging"},{"key":"2025081218290444900_bib37","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1054\/mehy.1999.0016","article-title":"Is mitral valve prolapse a manifestation of adolescent growth spurt?","volume":"54","author":"Kumar","year":"2000","journal-title":"Med Hypotheses"},{"key":"2025081218290444900_bib38","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1159\/000006904","article-title":"Long-term site-related differences in the progression and regression of the idiopathic mitral valve Prolapse Syndrome","volume":"91","author":"Kamei","year":"1999","journal-title":"Cardiology"},{"key":"2025081218290444900_bib39","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1016\/s0002-9149(77)80100-8","article-title":"Echocardiographic spectrum of mitral valve motion in children with and without mitral valve prolapse: the nature of false positive diagnosis","volume":"39","author":"Sahn","year":"1977","journal-title":"Am J Cardiol"},{"key":"2025081218290444900_bib40","first-page":"13","article-title":"Prevalence of mitral valve prolapse in healthy adult Nigerians as diagnosed by echocardiography","volume":"30","author":"Oladapo","year":"2001","journal-title":"Afr J Med Med Sci"},{"key":"2025081218290444900_bib41","doi-asserted-by":"publisher","first-page":"862382","DOI":"10.3389\/fcvm.2022.862382","article-title":"Progression of mitral regurgitation in rheumatic valve disease: role of left atrial remodeling","volume":"e9","author":"Gomes","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2025081218290444900_bib42","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.amjcard.2019.01.026","article-title":"Predictive factors for progression of mitral regurgitation in asymptomatic patients with mitral valve prolapse","volume":"123","author":"Ma","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2025081218290444900_bib43","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1159\/000324313","article-title":"Natural history of mitral valve prolapse in military aircrew","volume":"118","author":"Wand","year":"2011","journal-title":"Cardiology"},{"key":"2025081218290444900_bib44","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1016\/j.echo.2020.01.016","article-title":"Mitral valve prolapse patients with less than moderate Mitral regurgitation exhibit early cardiac chamber remodelling","volume":"33","author":"Yang","year":"2020","journal-title":"J Am Soc Echocardiogr"},{"key":"2025081218290444900_bib45","doi-asserted-by":"publisher","first-page":"e022332","DOI":"10.1161\/JAHA.121.022332","article-title":"Mitral valve prolapse induces regionalized myocardial fibrosis","volume":"10","author":"Morningstar","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2025081218290444900_bib46","doi-asserted-by":"publisher","first-page":"2752","DOI":"10.1016\/j.jtcvs.2014.07.029","article-title":"Left ventricular dysfunction after mitral valve repair\u2014the fallacy of \u201cnormal\u201d preoperative myocardial function","volume":"148","author":"Quintana","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025081218290444900_bib47","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1161\/CIRCULATIONAHA.117.033173","article-title":"Clinical outcomes of degenerative mitral regurgitation: critical importance of echocardiographic quantitative assessment in Routine practice","volume":"138","author":"Antoine","year":"2018","journal-title":"Circulation"},{"key":"2025081218290444900_bib48","first-page":"10","article-title":"Deaths: leading causes for 2022","volume":"73","author":"Curtin","year":"2024","journal-title":"Natl Vital Stat Rep"}],"container-title":["European Heart Journal - Quality of Care and Clinical Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjqcco\/advance-article-pdf\/doi\/10.1093\/ehjqcco\/qcaf016\/62807407\/qcaf016.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjqcco\/article-pdf\/11\/5\/631\/62807407\/qcaf016.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjqcco\/article-pdf\/11\/5\/631\/62807407\/qcaf016.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T22:29:08Z","timestamp":1755037748000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjqcco\/article\/11\/5\/631\/8099945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":48,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3,28]]},"published-print":{"date-parts":[[2025,8,11]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjqcco\/qcaf016","relation":{},"ISSN":["2058-5225","2058-1742"],"issn-type":[{"value":"2058-5225","type":"print"},{"value":"2058-1742","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,3,28]]}}}