Intermountain Health to use grant to study patients with heart problem
When Bill Beeston was a child, he was diagnosed with a heart murmur. At the time of his diagnosis, he didn’t have any adverse symptoms.
When he got older, however, he started to notice he would get short winded while mowing the lawn or being in higher elevations.
That’s when doctors discovered he had a condition called mitral valve prolapse with regurgitation.
“It means blood was flowing back into my heart instead of being pushed out,” the Provo resident said during a press conference on Monday. “That’s a problem, so they started to monitor me and over the years it just got worse.”
Beeston was given several treatment options and ended up being eligible for a study being conducted by Intermountain Health. He enrolled and had a surgical procedure to fix the problem by placing a tiny clip, called a MitraClip, in the heart to repair the leaky valve — and today, he said, he feels great.
“When I woke up, I could actually feel oxygen flowing through my body,” he said. “I had more energy and I felt an amazing difference.”
Mitral valve prolapse is a condition that occurs when the heart’s mitral valve leaflets don’t close properly, which causes blood to leak backward into the left atrium. The condition affects between 2% and 3% of the general population, or approximately 7.8 million Americans and more than 176 million people around the globe. It can be caused by several heritable factors and is associated with a myriad of diseases including scoliosis, von Willebrand syndrome, muscular dystrophy and connective tissue disorders.
Symptoms can include a racing heartbeat, fatigue, shortness of breath, chest pain and dizziness. While many people live without the condition ever affecting their health, others can go on to develop heart failure, arrhythmias or even death.
Because the condition is so common, cardiac researchers at Intermountain Health were excited to announce they received a $2.4 million four-year federal grant from the National Institutes of Health to allow them to study additional ways to improve care for those patients.
“This study will allow us to evaluate more precisely who is going to develop moderate to severe mitral valve prolapse and moderate to severe related health problems,” said Dr. Benjamin Horne, 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.”
Horne said through the grant, Intermountain researchers will retroactively evaluate the electronic health records of thousands of patients going back to the 1990s to identify those who have been diagnosed with the condition. The study also will allow researchers to identify factors predicting whether mitral valve prolapse affected a patient and the most common denominator in those poor outcomes.
“As cardiologists, we are quite accustomed to diagnosing and managing mitral valve prolapse-associated mitral regurgitation,” said Dr. Brian Whisenant, structural heart cardiologist at Intermountain Health and co-investigator of the 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.”
The 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. They hope to create a score that will allow physicians to 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,” Horne said.
If someone receives a high score, they could be better tracked and monitored and know that surgery might be necessary in the future.
“This study will help doctors know when mitral valve prolapse is a clue that warrants further investigation and when patients can be reassured,” Whisenant said. “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.”