Intermountain Researchers Receive $2.4 Million Grant to Study Common Heart Disorder

Cardiac researchers at Intermountain Health have received a $2.4 million, four-year federal grant from the National Institutes of Health to study ways to enhance care for the millions of Americans who suffer from a common, and potentially fatal, heart condition.

Intermountain Health heart researchers will use the NIH grant to study ways to enhance monitoring and treatment for patients who experience mitral valve prolapse, a condition that occurs when the heart’s mitral valve leaflets don’t close properly, allowing blood to leak backward into the left atrium.

Mitral valve prolapse affects between 2% and 3% of the general population, which is roughly 7.8 million people in the United States and more than 176 million people worldwide.

Symptoms of mitral valve prolapse may include a racing heartbeat, dizziness, shortness of breath, fatigue, and chest pain. However, for many patients, mitral valve prolapse doesn’t cause any symptoms.

Many mitral valve prolapse patients live with the heart condition their whole lives without it ever affecting their health. In other people, it can lead to additional heart disease, such as heart failure or arrhythmias, and even death.

“This study will allow us to evaluate more precisely who is going to develop moderate to severe MVP and moderate to severe-related health problems,” said Benjamin Horne, PhD, principal investigator of the study and director of cardiovascular and genetic epidemiology at Intermountain Health. “We will be more aware of someone potentially needing more intense therapy or more frequent follow up and follow them to ensure that their health is being maintained.”

When a mitral valve prolapses, the valve between the heart’s upper and lower chambers doesn’t close properly. The main complication of mitral valve prolapse is mitral regurgitation, where blood leaks backwards, and therefore doesn’t efficiently deliver oxygen throughout the body.

Mitral valve prolapse is one of the most common causes of mitral regurgitation. If the leak is severe enough, a person may need surgery to repair or replace the valve.

Heart valve regurgitation is common globally. In the United States, mitral valve regurgitation is the most common form of heart valve disease.

“As cardiologists, we are quite accustomed to diagnosing and managing mitral valve prolapse associated mitral regurgitation,” said Brian Whisenant, MD, structural heart cardiologist at Intermountain Health and co-investigator of this study. “However, by focusing on leaking values we are certainly ignoring most of the iceberg. This study looks at that whole iceberg, not just the tip.”

Through this grant, Intermountain researchers will retroactively evaluate the electronic health records of tens of thousands of Intermountain patients, going back to the 1990s.They will identify people who have been diagnosed with mitral valve prolapse, which is typically done through an echocardiogram, and follow their outcomes.

The Intermountain study will allow researchers to identify factors that could predict whether mitral valve prolapse affected a patient, and what is most common in those with poor outcomes.

Mitral valve prolapse can be caused by several heritable factors and is associated with a variety of diseases including connective tissue disorders, Graves’ disease, scoliosis, von Willebrand syndrome, and muscular dystrophy.

Intermountain researchers will work with Intermountain’s HerediGene: Population Study  to identify genetic markers for mitral valve prolapse, and Intermountain’s genealogy registry to identify families in whom mitral valve prolapse is common.

Overall, Intermountain researchers hope to create a score that will allow physicians to, upon diagnosing mitral valve prolapse, determine if “this is really going to be benign or is this something they should start considering right now when they don’t have the health problems that can arise from it,” said Dr. Horne.

For example, if someone scores high, they can be better tracked and monitored and know that surgery might be necessary in the future, Dr. Horne added.

“This study will help doctors know when mitral valve prolapse is a clue that warrants further investigation and when patients can be reassured,” said Dr. Whisenant. “In some ways, it’s like asking a dermatologist if a spot is anything to worry about. Most spots are freckles, but some are cancer. We hope this study will help us develop methods to better make that determination for patients with mitral valve prolapse.”

The grant is supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL172982. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.