Modern Pediatrics. Ukraine. (2026).4(156): 62-67. doi: 10.15574/SP.2026.4(156).6267
Kuleshov O. V., Kurets O. O., Chygir I. V., Kravets R. A., Oliynyk V. S., Andrikevich I. I., Shalamay M. O.
National Pirogov Memorial Medical University, Vinnytsya, Ukraine

For citation: Kuleshov OV, Kurets OO, Chygir IV, Kravets RA, Oliynyk VS, Andrikevich II, Shalamay MO. (2026). Method for assessing the state of intracardial hemodynamics in children with mitral valve prolapse during physical exercise. Modern Pediatrics. Ukraine. 4(156): 62-67. doi: 10.15574/SP.2026.4(156).6267.Article received: Jan 23, 2026. Accepted for publication: May 12, 2026.
Cardiovascular system pathology in children remains a relevant problem nowdays. In recent years, increasing attention has been devoted to the study of mitral valve prolapse (MVP) in children.

Aim – to assess the response of the cardiovascular system to physical exercise in children with MVP, taking into account the presence of mitral regurgitation (MR).
Materials and methods. A total of 110 children (main group) aged 13-17 years with primary (idiopathic) MVP were examined. The children were divided into subgroups according to the presence of MR. The subgroup without MR comprised 66 children (60.0%), while the subgroup with MR comprised 44 children (40.0%). The control group consisted of 23 apparently healthy children of comparable age. The morphofunctional state of the heart and parameters of intracardiac hemodynamics were assessed using Doppler echocardiography at rest and after physical exercise.
Results. In children with MVP without MR, cardiac contractile function increased as expected with the increased ejection fraction (EF). Stroke volume (SV) also increased in children with MVP without MR. In children with MVP and MR, a similar tendency toward an increase in EF was observed (p<0.05).
Conclusions. Children with MVP, regardless of the presence or absence of MR, constitute a risk group for complications during physical exercise.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent to participate in the study was obtained from the parents and children.
The authors declare no conflict of interest.
Keywords: children, autonomic regulation, cardio-vascular pathology, mitral valve prolapse, mitral, assessment method, echocardiography, Doppler, physical therapy.

REFERENCES

1. Aluru JS, Barsouk A, Saginala K, Rawla P, Barsouk A. (2022). Valvular Heart Disease Epidemiology. Medical sciences (Basel, Switzerland). 10(2): 32. https://doi.org/10.3390/medsci10020032; PMid:35736352 PMCid:PMC9228968

2. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons et al. (2006). ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. 114(5): e84-e231. https://doi.org/10.1161/CIRCULATIONAHA.106.176857

3. Amosova KM, Zhadan AV. (2024). Prolaps mitralnoho klapana. Liky Ukrainy. 4-5(280-281): 27-32. https://doi.org/10.37987/1997-9894.2024.4-5(280-281).316352

4. Boudoulas KD, Pitsis AA, Boudoulas H. (2016). Floppy Mitral Valve (FMV) – Mitral Valve Prolapse (MVP) – Mitral Valvular Regurgitation and FMV/MVP Syndrome. Hellenic journal of cardiology: HJC = Hellenike kardiologike epitheorese. 57(2): 73-85. https://doi.org/10.1016/j.hjc.2016.03.001; PMid:27445020

5. Boudoulas KD, Pitsis AA, Mazzaferri EL, Gumina RJ, Triposkiadis F, Boudoulas H. (2020). Floppy mitral valve/mitral valve prolapse: A complex entity with multiple genotypes and phenotypes. Progress in cardiovascular diseases. 63(3): 308-326. https://doi.org/10.1016/j.pcad.2020.03.004; PMid:32201287

6. Cavarretta E, Peruzzi M, Versaci F, Frati G, Sciarra L. (2021). How to manage an athlete with mitral valve prolapse. European journal of preventive cardiology. 28(10): 1110-1117. https://doi.org/10.1177/2047487320941646; PMid:32731762

7. Delling F, Noseworthy P, Adams D et al. (2022). Research Opportunities in the Treatment of Mitral Valve Prolapse: JACC Expert Panel. JACC. 80(24): 2331-2347. https://doi.org/10.1016/j.jacc.2022.09.044; PMid:36480975 PMCid:PMC9981237

8. Elendu C, Babarinde FO, Babatunde OD, Babawale EA, Hassan JI, Ikeji VI et al. (2025). Risk stratification and management of arrhythmias in patients with Wolff-Parkinson-White syndrome. Annals of medicine and surgery (2012). 87(5): 2702-2717. https://doi.org/10.1097/MS9.0000000000003068; PMid:40337375 PMCid:PMC12055097

9. Esposito A, Gatti M, Trivieri MG, Agricola E, Peretto G, Gallone G et al. (2024). Imaging for the assessment of the arrhythmogenic potential of mitral valve prolapse. European radiology. 34(7): 4243-4260. https://doi.org/10.1007/s00330-023-10413-9; PMid:38078997 PMCid:PMC11164824

10. Kubala M, Essayagh B, Michelena HI, Enriquez-Sarano M, Tribouilloy C. (2023). Arrhythmic mitral valve prolapse in 2023: Evidence-based update. Front. Cardiovasc. Med. 10: 1130174. https://doi.org/10.3389/fcvm.2023.1130174; PMid:37144062 PMCid:PMC10153002

11. Lancellotti P, Moura L, Pierard LA, Agricola E, Popescu BA, Tribouilloy C et al. (2010). European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology. 11(4): 307-332. https://doi.org/10.1093/ejechocard/jeq031; PMid:20435783

12. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. (2015). Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography. 28(1): 1-39.e14. https://doi.org/10.1016/j.echo.2014.10.003; PMid:25559473 PMCid:PMC10889072

13. Mitiuriaieva-Korniiko IO, Kuleshov OV, Pivtorak KV, Medrazhevska YaA, Fik LO. (2023). Response of autonomic nervous system in children with mitral valve prolapse to physical exercises. Modern Pediatrics. Ukraine. 3(131): 46-51. https://doi.org/10.15574/SP.2023.131.46

14. Palmisano A, Nicoletti V, Colantoni C et al. (2021). Dynamic changes of mitral valve annulus geometry at preprocedural CT: relationship with functional classes of regurgitation. Eur Radiol Exp. 5(1): 34. https://doi.org/10.1186/s41747-021-00231-3; PMid:34386843 PMCid:PMC8360976

15. Perone F, Loguercio M, Sabato F, Pasquini A, Ostojic M, Avagimyan A et al. (2025). Cardiac Rehabilitation After Mitral Valve Intervention: Tailored Assessment, Management, and Exercise Training. Journal of Cardiovascular Development and Disease. 12(7): 265. https://doi.org/10.3390/jcdd12070265; PMid:40710790 PMCid:PMC12295730

16. Perone F, Peruzzi M, Conte E, Sciarra L, Frati G et al. (2023). An Overview of Sport Participation and Exercise Prescription in Mitral Valve Disease. Journal of cardiovascular development and disease. 10(7): 304. https://doi.org/10.3390/jcdd10070304; PMid:37504560 PMCid:PMC10380819

17. Ronco D, Buttiglione G, Garatti A, Parolari A. (2023). Biology of mitral valve prolapse: from general mechanisms to advanced molecular patterns – a narrative review. Front. Cardiovasc. Med. 10: 1128195. https://doi.org/10.3389/fcvm.2023.1128195; PMid:37332582 PMCid:PMC10272793

18. Roselli C, Yu M, Nauffal V, Georges A, Yang Q, Love K et al. (2022). Genome-wide association study reveals novel genetic loci: a new polygenic risk score for mitral valve prolapse. European heart journal. 43(17): 1668-1680. https://doi.org/10.1093/eurheartj/ehac049; PMid:35245370 PMCid:PMC9649914

19. Roth GA, Mensah GA, Fuster V. (2020). The Global Burden of Cardiovascular Diseases and Risks: A Compass for Global Action. Journal of the American College of Cardiology. 76(25): 2980-2981. https://doi.org/10.1016/j.jacc.2020.11.021; PMid:33309174

20. Sabbag A, Essayagh B, Barrera JDR, Basso C, Berni A, Cosyns B et al. (2022). EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 24(12): 1981-2003. https://doi.org/10.1093/europace/euac125; PMid:35951656

21. Tekerlek H, Özcan EB, Çetin T, Sağlam M, Vardar-Yağlı N et al. (2025). Physical activity level and influencing factors in pediatric Wolff-Parkinson-White syndrome patients: A case-control study. European journal of pediatrics. 184(8): 475. https://doi.org/10.1007/s00431-025-06290-7; PMid:40634817 PMCid:PMC12241136

22. Washington RL, Goldberg B. (1993) Mitral Valve Prolapse in Active Youth. The Physician and Sportsmedicine. 21(1): 136-144. https://doi.org/10.1080/00913847.1993.11710320; PMid:27414833