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Journal of the American College of... May 2019Unlike secondary mitral regurgitation (MR) in the setting of left ventricular (LV) disease, the occurrence of functional MR in atrial fibrillation (AF) and/or heart... (Review)
Review
Unlike secondary mitral regurgitation (MR) in the setting of left ventricular (LV) disease, the occurrence of functional MR in atrial fibrillation (AF) and/or heart failure with preserved ejection fraction (HFpEF) has remained largely unspoken. LV size and systolic function are typically normal, whereas isolated mitral annular dilation and inadequate leaflet adaptation are considered mechanistic culprits. Moreover, the role of left atrial and annular dynamics in provoking MR is often underappreciated. Because of this peculiar pathophysiology, atrial functional MR benefits from a different approach compared with secondary MR. Although both AF and HFpEF-two closely related disease epidemics of the 21st century-are held responsible, current guidelines do not emphasize the need to differentiate atrial functional MR from (ventricular) secondary MR. This review summarizes the prevalence and prognostic importance of atrial functional MR, providing mechanistic insights compared with those of secondary MR and suggesting potential therapeutic targets.
Topics: Atrial Fibrillation; Heart Atria; Heart Failure; Humans; Mitral Valve; Mitral Valve Insufficiency; Prevalence; Prognosis; Stroke Volume
PubMed: 31097168
DOI: 10.1016/j.jacc.2019.02.061 -
Hellenic Journal of Cardiology : HJC =... 2021
Topics: Humans; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Stenosis
PubMed: 33771729
DOI: 10.1016/j.hjc.2021.03.002 -
JACC. Cardiovascular Interventions Oct 2021
Topics: Heart Valve Prosthesis; Humans; Mitral Valve; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 34600872
DOI: 10.1016/j.jcin.2021.08.040 -
F1000Research 2019Interest in the mitral valve has increased over the past few years with the development of new technologies that allow intervention in patients previously deemed too ill... (Review)
Review
Interest in the mitral valve has increased over the past few years with the development of new technologies that allow intervention in patients previously deemed too ill for treatment. This increased attention has resulted in a significant increase in publications on the mitral valve, the majority of which focus on mitral regurgitation and mitral valve surgery/intervention. The focus of this review is on publications in the past few years that offer additional insights into our understanding and management of mitral valve disease and specifically mitral regurgitation. It will discuss mitral valve anatomy, epidemiology of mitral valve disease, changes in the 2017 management guidelines, management of mitral bioprosthetic valves, transcatheter mitral valve procedures and the repair of rheumatic valves.
Topics: Cardiac Surgical Procedures; Heart Valve Diseases; Humans; Mitral Valve; Mitral Valve Insufficiency
PubMed: 31588355
DOI: 10.12688/f1000research.16066.1 -
Annals of Cardiac Anaesthesia 2017Ischemic mitral regurgitation (IMR) is a frequent complication of left ventricular (LV) global or regional pathological remodeling due to chronic coronary artery... (Review)
Review
Ischemic mitral regurgitation (IMR) is a frequent complication of left ventricular (LV) global or regional pathological remodeling due to chronic coronary artery disease. It is not a valve disease but represents the valvular consequences of increased tethering forces and reduced closing forces. IMR is defined as mitral regurgitation caused by chronic changes of LV structure and function due to ischemic heart disease and it worsens the prognosis. In this review, we discuss on etiology, pathophysiology, and mechanisms of IMR, its classification, evaluation, and therapeutic corrective methods of IMR.
Topics: Coronary Artery Disease; Humans; Mitral Valve; Mitral Valve Insufficiency; Myocardial Ischemia
PubMed: 28994679
DOI: 10.4103/aca.ACA_58_17 -
Circulation. Cardiovascular Imaging Dec 2020
Topics: Echocardiography, Three-Dimensional; Humans; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Prolapse; Myocardial Infarction
PubMed: 33317331
DOI: 10.1161/CIRCIMAGING.120.012130 -
Archives of Cardiovascular Diseases Dec 2022
Topics: Humans; Mitral Valve; Heart Valve Diseases; Calcinosis; Heart Defects, Congenital; Mitral Valve Stenosis; Mitral Valve Insufficiency
PubMed: 36347773
DOI: 10.1016/j.acvd.2022.09.005 -
Circulation Journal : Official Journal... 2014Mitral valve repair is the gold standard treatment for mitral regurgitation. The history of mitral valve repair and its refinement in terms of the technique used will... (Review)
Review
Mitral valve repair is the gold standard treatment for mitral regurgitation. The history of mitral valve repair and its refinement in terms of the technique used will show the evolution of this surgical technique. The standard technique we use for mitral valve repair is described, and the outcomes we have observed over the past 4 decades are presented.
Topics: History, 20th Century; History, 21st Century; Humans; Mitral Valve Annuloplasty; Mitral Valve Insufficiency
PubMed: 24492161
DOI: 10.1253/circj.cj-14-0069 -
European Journal of Cardio-thoracic... Jun 2019Systolic heart failure is frequently accompanied by a relevant functional mitral valve regurgitation (FMR) which develops as a direct sequela of the ongoing left... (Review)
Review
Systolic heart failure is frequently accompanied by a relevant functional mitral valve regurgitation (FMR) which develops as a direct sequela of the ongoing left ventricular remodelling. The severity of mitral regurgitation is further aggravated by progressive left ventricular enlargement causing leaflet tethering and reduced systolic leaflet movement. The prognosis of such patients is obviously limited by an underlying left ventricular disease, and the correction of secondary FMR has been previously suggested as predominantly 'cosmetic' surgery in the setting of ongoing cardiomyopathy. Inferior results of an isolated annuloplasty in type IIIb FMR supported the philosophy of malignant course of progressive cardiomyopathy and resulted in increasingly restricted indications for mitral valve surgery for FMR in the guidelines. The lack of a standardized pathophysiological approach to correct type IIIb FMR led to the development of valve replacement strategy and edge-to-edge catheter-based mitral valve procedures, which became the most frequent procedures in the FMR setting in Europe. Modern mitral valve surgery combines the advantages of 3-dimensional endoscopic minimally invasive surgical approach with standardized subannular repair to address the pathophysiological background of type IIIb FMR. The perioperative results have been significantly improved, and there is a growing evidence of improved long-term stability of subannular repair procedures as compared to isolated annuloplasty. This review article aims to present the current state-of-the-art of the modern mitral valve surgery in FMR and provides suggestions for future trials analysing the potential advantages in these patients.
Topics: Heart Valve Prosthesis; Humans; Minimally Invasive Surgical Procedures; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Prognosis; Ventricular Remodeling
PubMed: 31106337
DOI: 10.1093/ejcts/ezy344 -
European Journal of Heart Failure Aug 2021
Topics: Heart Failure; Humans; Mitral Valve; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Registries
PubMed: 33929075
DOI: 10.1002/ejhf.2203