Therapeutic decision-making for patients with fluctuating mitral regurgitation

Review; Doppler echocardiography; Mitral Valve Insufficiency; Cardiac Resynchronization Therapy; Clinical Decision-Making; Echocardiography, Doppler; Echocardiography, Stress; Exercise; Humans; Mitral Valve; Mitral Valve Annuloplasty

Abstract :

[en] Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in MR and systolic pulmonary artery pressure during exercise. Identifying patients who have dynamic MR, and understanding the mechanisms underlying the condition, can potentially influence revascularization strategies (such as the surgical restoration of coronary blood flow) and interventional treatment (including cardiac resynchronization therapy and new approaches targeted to the mitral valve). © 2015 Macmillan Publishers Limited. All rights reserved.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Imagerie cardiaque fonctionnelle par échographie

Fattouch, K.; Cardiac Surgery Unit, GVM Care and Research, Maria Eleonora Hospital, Viale della Regione Siciliana Nord Ovest 1571, Palermo, Italy

La Canna, G.; Echocardiography Unit, Cardiac Surgery Department, San Raffaele Scientific Institute, Via Olgettina 58, Milan, Italy

Language :

English

Title :

Therapeutic decision-making for patients with fluctuating mitral regurgitation

Publication date :

2015

Journal title :

Nature Reviews. Cardiology

ISSN :

1759-5002

eISSN :

1759-5010

Publisher :

Nature Publishing Group

Volume :

Issue :

Pages :

212-219

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 02 September 2021

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