[The role of transforming growth factor-β in the pathogenesis of mitral valve prolapse].
Changes in activity of the components of TGF-β signaling pathway is associated with inherited disorders of connective tissue such as Marfan syndrome, Loeys-Dietz syndrome, etc. However, its impact on mitral valve prolapse (MVP) has not been completely studied. We examined 35 patients undergoing reconstructive surgery due MVP complicated by severe mitral insufficiency (mean age 62.5+/-7.9 years, 46% - men). High level of TGF-βl/2 was detected in majority (65%) of cases and correlated with the thickness of posterior leaflet (r=0.67; p=0.016), residual valve prolapse (r=0.68; p=0.007) and residual mitral regurgitation (MR) (r=0.56; p=0.01). In patients with high TGF-βl/2 level we detected a significant decrease in left ventricular longitudinal systolic (-13.5+/-2.2% vs. -16.6+/-2.3%, p=0.008) and diastolic (1.14+/-0.20 s-1 vs. 1.34+/-0.18 s-1, p=0.04) strain and SR (-0.89+/-0.15 s-1 vs. -1.14+/-0.15 s-1, p=0.002). Thus, TGF-β has a significant impact on the progression of valve myxomatous degeneration. The high activity of TGF-β signaling pathway results also in reduction in LV function, probably due to the profibrotic activity.