P210Long- term outcome of primary mitral valve prolapse: results from a population of 250 patients referred to a tertiary cardiovascular center.P211Rheumatic Heart Disease in Uganda - Results from more than 600 echocardiograms in a no-profit hospitalP212Higher ventricular ectopy burden in asymptomatic severe Barlows mitral valve disease compared to similar patients with mitral valve prolapseP213Surgical mitral valve repair for severe secondary mitral regurgitation: prognostic implications of left ventricular forward flowP214Multicentre trial results of a transfemoral annuloplasty system for mitral valve reconstruction -P215Comparative assessment of paravalvular leaks with 3D-transesophageal echocardiography and cardiac computed tomographyP216Failing surgical aortic bioprosthetic valves: redo aortic valve surgery versus percutaneous valve-in-valve replacementP217Mitral annular calcification and infective endocarditisP218Infective endocarditis - a changing diseaseP219Staphilococcus aureus bacteremia: application of the ESC proposed diagnostic echocardiographic algorithm in clinical practiceP220ESC proposed diagnostic echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis and negative blood cultures: diagnostic yield and prognostic implicationsP221Three-dimensional transesophageal echocardiography versus multidetector computed tomography for aortic annulus sizing in TAVI: a worthy alternativeP222Early and mid-term improvement in left ventricular function after transcatheter aortic valve replacement as assessed by myocardial strain imagingP223Dynamic of aortic root as predictor of paravalvular regurgitation after transcatheter aortic valve implantationP224Short term effect of heart rate reduction by Ivabradine on left ventricular function and remodeling in systolic heart failure patientsP225Global longitudinal strain and regional longitudinal strain in patients with hypertrophic cardiomyopathy: are they associated with the presence of myocardial fibrosis?P226Investigation of mitral leaflet elongation in patients with non-obstructive versus latent-obstructive hypertrophic cardiomyopathyP227Hypertrophic cardiomyopathy: to what degree have the new ESC guidelines been implemented in routine clinical practice? A retrospective audit assessing current practice in a large general UK hospitalP228New genotype-phenotype associations in hypertrophic cardiomyopathy patients studied with cardiac magnetic resonance with feature-trackingP229How many are too many - frequent premature ventricular contractions and left ventricular functionP230Two-dimensional global longitudinal strain and strain rate for evaluation of inflammatory cardiomyopathy as proven by endomyocardial biopsyP231The echocardiographic features of young asymptomatic screening population with left ventricular hypertrabeculationP232Use of amlodipine to decrease myocardial iron in thalassemia major (AMIT trial): comparison of T2* CMR and echocardiography for assessment of cardiac volumes and functionP233Echocardiographic comparison of Fabry cardiomyopathy and light-chain amyloid heart diseaseP234Early detection of left atrial enlargement using 3D echocardiography in patients undergoing breast cancer treatment

Background Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Purpose To make a contemporary survey on the incidence of cardiovascular events in a selected population of patients affected by primary MVP referred to a tertiary cardiovascular center for the medical and surgical care of valvular heart disease. Methods We reviewed our MVP database; patients with at least 2 cardiologic evaluations inclusive of echocardiographic examination and at least 6 months follow up were enrolled. A total of 250 patients (126 F) were selected. Their mean age was 52.1 years (ranging from 13 to 88 yo). The average follow-up time was 100 months (8,33 yrs). Results At the first medical and echocardiographic examination 8 patients (3,2%) had no mitral regurgitation (MR), 104 (41.6%) have a trace/mild MR, 93 (37,2%) a moderate MR and 46 (18,4%) a severe MR. They were widely asymptomatic (NYHA I 205-82%, NYHA II 44-17.60%, NYHA III 1- 0.40%). Most of theme presented a bileaflet (140-55.8%) or a posterior MVP (94 - 37.6%); an isolated anterior MVP was rare (16 - 6,4%). Flail leaflet was present in 8 (3,2%) and 25 (10%) had a chordal rupture. Respectively 165 (65,6%) and 115 (46,1%) patients had thick and redundant leaflets. Mean antero-posterior mitral annulus diameter was 37 mm. During the follow up 7 patients died of non-cardiac cause and 5 (2%) of suspected cardiac cause (2 because of acute coronary syndrome and 3 died suddenly). MR progresses in 43 (17,2%) patients and finally we observed 81 (32,4%) moderate/severe and severe MR. 12 new chordal rupture occurred during the follow up in most cases concerning mitral chordae linked to posterior mitral leaflet (10 cases-83,3%). The worsening of MR provoked an evolution of the clinical condition of 48 patients (19.2%) which developed Dyspnea On Excertion (DOE) with 42 new NYHA II and 6 new NYHA III. At the end of the follow up the amount of patients symptomatic for DOE was 93 (37.2% vs 18% at the initial evaluation). A total of 45 patients (18%) underwent mitral valve surgery. 40 needed in-hospital treatment in most cases due to the development of atrial fibrillation (19 -7.6%) or heart failure ( 8- 3,2%). Endocarditis occurred in 4 patients (1.6%) and cerebrovascular accidents/cardioembolic event in 6 (2.4%). The overall cardiovascular event rate was 4,33/100 patients-year, significantly higher than reported in community based studies. Conclusions The prognosis of a MVP population referred to a tertiary cardiovascular center is not benign. The most frequent complications are progression of MR and MV surgery. Sudden death is also more frequent than in general population. More studies are needed to identify what patients with MVP are at risk for it.