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Mitral Valve Prolapse (MVP) in Psoriatic Arthritis (PA)-Reply

Michael Ehrenfeld, MD; Enrique Z. Fisman, MD; Amos Pines, MD
Arch Intern Med. 1987;147(5):992. doi:10.1001/archinte.1987.00370050184033.
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We read with great interest that Moya and coworkers were also looking for valvular abnormalities in patients with psoriatic arthritis (PA), but did not find a higher rate of mitral valve prolapse (MVP) among those patients. They pointed out that we might have overdiagnosed MVP because of methodologic limitations.1 Our examinations were performed with a mechanical sector scanner utilizing both M-mode and 2D-echocardiography. However, we chose the classic M-mode diagnostic criteria because of their high sensitivity (85%) and specificity (99%).2 Furthermore, all echocardiograms were recorded and analyzed by two independent experienced echocardiographists in real-time, slow-motion, and stop-action modes. The examiners were blind to the purposes of the study. In a case of overdiagnosis, this should have been reflected in the control group as well. In any case, auscultatory findings compatible with MVP were detected in over 70% of our study group, but in none of the control


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