Volume 140A, Issue 2 pp. 129-136
Research Article
Free Access

Echocardiographic findings in classical and hypermobile Ehlers–Danlos syndromes

Nazli B. McDonnell

Corresponding Author

Nazli B. McDonnell

Human Genetics and Integrative Medicine Section, Laboratory of Genetics, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

National Institute on Aging, 5600 Nathan Shock Drive, Room 3101, Baltimore, MD 21224.Search for more papers by this author
Beverly L. Gorman

Beverly L. Gorman

Clinical Research Branch, NIA-ASTRA Unit, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

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Katherine W. Mandel

Katherine W. Mandel

Human Genetics and Integrative Medicine Section, Laboratory of Genetics, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

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Shepherd H. Schurman

Shepherd H. Schurman

Clinical Research Branch, NIA-ASTRA Unit, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

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Alison Assanah-Carroll

Alison Assanah-Carroll

Clinical Research Branch, NIA-ASTRA Unit, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

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Susan A. Mayer

Susan A. Mayer

Cardiology Division, Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore, Maryland

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Samer S. Najjar

Samer S. Najjar

Human Cardiovascular Studies Unit, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

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Clair A. Francomano

Clair A. Francomano

Human Genetics and Integrative Medicine Section, Laboratory of Genetics, National Institute on Aging, National Institutes of Health, Baltimore, Maryland

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First published: 13 December 2005
Citations: 71

This article is a US Government work and, as such, is in the public domain in the United States of America.

Abstract

Structural cardiovascular alterations in the classical and hypermobile forms of Ehlers–Danlos syndrome(EDS) warrant investigation. We have examined a cohort of 38 patients with hypermobile and classical EDSs using two-dimensional echocardiography. The cohort includes 7 males and 31 females, with an age range from 12–60 years. Altered echocardiographic parameters were seen in the initial cross-sectional data analysis in 24/38 patients. Five of the 38 participants had mildly dilated aortic root (AR) or sinuses of Valsalva (SV), and an additional 7 patients had an abnormal pouching of the SV, although the absolute dimensions did not exceed the normal range. Ten patients had mild mitral, tricuspid, or aortic regurgitation, and only one patient had mitral valve prolapse (MVP). Three patients had low normal systolic function; three had evidence of mildly elevated pulmonary pressures, and two patients had mild concentric left ventricular hypertrophy (LVH). Five patients had evidence of impaired left ventricular relaxation (LVR) based on mitral valve E to A velocity ratio. Interestingly, 26/38 subjects demonstrated a prominent right coronary artery (RCA) easily visualized by trans-thoracic echocardiography, and 10/38 had an elongated cardiac silhouette on the 4-chamber apical views. The “pouching” shape of the SV was more common in hypermobile type than in the classical type of EDS. The study is ongoing and will accrue longitudinal data on 100 subjects with classical and hypermobile EDSs at 2-year intervals. Published 2005 Wiley-Liss, Inc.

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