Mitral valve disease--morphology and mechanisms

Nature Reviews. Cardiology
Robert A LevineLeducq Mitral Transatlantic Network

Abstract

Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but--even in adult life--remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular-ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists...Continue Reading

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Related Concepts

Mitral Valve Insufficiency
Hypertrophic Cardiomyopathy
Complication
Cessation of Life
Growth Factor
Heart Failure
Mitral Valve
Diseases of Mitral Valve
Mitral Valve Insufficiency
Nerve Degeneration

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