Mechanical dyssynchrony and functional mitral regurgitation: pathophysiology and clinical implications

Journal of Cardiovascular Medicine
Eustachio AgricolaEchocardiographic Study Group of the Italian Society of Cardiology

Abstract

Functional mitral regurgitation (FMR) is a common finding in patients with ischemic or nonischemic dilated cardiomyopathy as a complication of left ventricular (LV) dysfunction and remodeling associated with a fibrotic remodeling response of mitral leaflets to abnormal valvular loading. Although mitral valve tenting is the main determinant of FMR, clinical and experimental observations suggest that intraventricular delay could be a potential co-determinant of FMR. LV dyssynchrony can potentially contribute to FMR by several mechanisms, such as creating an uncoordinated regional LV mechanical activation in segments supporting the papillary muscles, determining diastolic mitral regurgitation, reducing the sphincteric function of the mitral annulus, and decreasing the efficiency of LV contraction and closing forces. Cardiac resynchronization therapy has been demonstrated to reduce FMR with correction of some of the underlying pathophysiological mechanisms. The present review article focuses on the role of mechanical dyssynchrony as a pathophysiological determinant of FMR, and on the potential role of cardiac resynchronization therapy as a therapeutic option for treatment of FMR in patients with severe heart failure and advanced LV...Continue Reading

References

Feb 1, 1988·The American Journal of Cardiology·B BarzilaiA S Jaffe
Jun 1, 1987·The American Journal of Cardiology·J SanadaS Hashimoto
Nov 1, 1993·The American Journal of Cardiology·H N SabbahS Goldstein
Feb 25, 1998·The Journal of Thoracic and Cardiovascular Surgery·S F BollingD S Bach
Sep 25, 1999·The American Journal of Cardiology·A N NeskovićA D Popović
Mar 22, 2001·The New England Journal of Medicine·S CazeauUNKNOWN Multisite Stimulation in Cardiomyopathies (MUSTIC) Study Investigators
Jun 26, 2001·The American Journal of Cardiology·J A Erlebacher, S Barbarash
Nov 13, 2001·Journal of the American College of Cardiology·F LebrunL A Piérard
Jun 14, 2002·The New England Journal of Medicine·William T AbrahamUNKNOWN MIRACLE Study Group. Multicenter InSync Randomized Clinical Evaluation
Apr 2, 2003·Circulation·Martin G St John SuttonUNKNOWN Multicenter InSync Randomized Clinical Evaluation (MIRACLE) Study Group
May 29, 2003·JAMA : the Journal of the American Medical Association·James B YoungUNKNOWN Multicenter InSync ICD Randomized Clinical Evaluation (MIRACLE ICD) Trial Investigators
Dec 10, 2003·Journal of the American College of Cardiology·Patrizio LancellottiLuc A Piérard
Mar 6, 2004·The Journal of Thoracic and Cardiovascular Surgery·Hari R MallidiStephen E Fremes
May 21, 2004·The New England Journal of Medicine·Michael R BristowUNKNOWN Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators
Sep 3, 2004·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Eustachio AgricolaOttavio Alfieri
Oct 16, 2004·The New England Journal of Medicine·Luc A Piérard, Patrizio Lancellotti
Nov 30, 2004·The American Journal of Cardiology·Patrizio LancellottiLuc A Piérard
Dec 8, 2004·Journal of the American College of Cardiology·Pierre BordacharJacques Clementy
Jan 18, 2005·Journal of the American College of Cardiology·Francesco GrigioniMaurice Enriquez-Sarano

❮ Previous
Next ❯

Citations

Jul 15, 2009·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Konstantinos A TriantafyllouDimitrios Babalis
Mar 14, 2014·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Sevil HemayatAmirhossein Sami Aldoboni
Aug 4, 2016·Indian Pacing and Electrophysiology Journal·Elisa EbrilleSamuel J Asirvatham
Mar 20, 2010·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Kursat TigenYelda Basaran
Aug 20, 2016·Journal of Cardiovascular Medicine·Giovanni BenfariCorrado Vassanelli
Apr 5, 2014·Echocardiography·Piotr SzymańskiPiotr Hoffman
Jul 18, 2017·Heart Failure Reviews·Donato MeleRoberto Ferrari
Jan 12, 2021·European Heart Journal. Case Reports·Quan LiXianhong Shu

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.