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Open Access Hypothesis

Reverse Δ-wave as a possible sign in electrocardiography to diagnose mitral valve prolapse

Azin Alizadeh-Asl

Author Affiliations

Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

BMC Research Notes 2011, 4:16  doi:10.1186/1756-0500-4-16

Published: 25 January 2011



Mitral valve prolapse (MVP) is defined as superior displacement of the mitral valve leaflets more than 2 mm into the left atrium during systole. Easier and cheaper assessment of this common disease is a priority in cardiac health care facilities.

Presentation of the hypothesis

In this study I addressed electrocardiographic presentation in 300 patients with MVP compared with 100 healthy individuals. I faced a novel finding in electrocardiogram (ECG) examination of these patients. It was a notch (reverse Δ-wave) in descending arm of QRS observed in 79% (237/300) of patients, consisting of 58% (174/300) in inferior leads and 21% (63/300) in I and aVL leads. The notch was identified only in 6 men in control group.

Testing the hypothesis

Considering the relatively higher prevalence of disease, a population-based diagnostic clinical trial study is appropriate to test the hypothesis.

Implications of the hypothesis

The hypothesis on diagnostic value of reverse Δ-wave in MVP may help in decreasing the rate of unnessessary echocardiography in some patients.