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Purpose: In some inherited connective tissue diseases with involving of the cardiovascular system, e.g. Marfan syndrome, has been reported early impairment of left ventricular (LV) systolic function, which have been described as Marfan-related cardiomyopathy. Our aim was to evaluate the left ventricular function in young adults with mitral valve prolapse (MVP) without significant mitral regurgitation (MR) using two-dimensional strain imaging.Methods: We studied 78 asymptomatic young subjects (mean age 19,7±1,6, 72% male) with MVP from REPLICA study (pREvalence of mitral valve ProLapse In young Adults) in comparison with 80 sex- and age-matched healthy subjects. MVP was diagnosed by billowing of 1 or both mitral leaflets >2 mm above the mitral annulus in the long-axis parasternal view. Longitudinal strain and strain rate (SR) were determined from three standard apical views, using spackle tracking, for each LV wall (Vivid 7 Dimension, EchoPAC'08) with grey-scale frame rate 50-55/sec.Results: During the k-means clustering we have identified two clusters of young subjects with MVP. In the first cluster (17 subjects, 28% of the MVP group) observed a significant reduction in global and regional longitudinal systolic strain and diastolic SRe compared with the control group and the second cluster (61 subjects, 72%) (Table). Global strain in the second cluster did not differ significantly from the control group, but there are significant decrease of local longitudinal systolic strain and diastolic SRe in interventricular septum.Conclusions: These changes of deformation may be the first signs of deterioration of the LV systolic function and existing of cardiomyopathy in inherited connective tissue disorder (MVP).