From secondary to tertiary mitral regurgitation: the paradigm shifts, but uncertainties remain.
Details
Serval ID
serval:BIB_34504024C241
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
From secondary to tertiary mitral regurgitation: the paradigm shifts, but uncertainties remain.
Journal
European heart journal. Cardiovascular Imaging
ISSN
2047-2412 (Electronic)
ISSN-L
2047-2404
Publication state
Published
Issued date
20/07/2021
Peer-reviewed
Oui
Volume
22
Number
8
Pages
835-843
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Secondary mitral regurgitation (MR) is the most common and undertreated form of MR, whose contribution to poor prognosis and indications to correction remains under discussion. MR has been characterized into 'proportionate' or 'disproportionate', based on left ventricle (LV) and regurgitant volumes, whereas 'tertiary' MR identifies conditions, in which regurgitation is pathologic per se and actively contributes to LV dysfunction. Echocardiographic and anatomo-pathological studies revealed that secondary MR prompts subtle leaflet maladaptive changes, actively contributing to the dynamic progression of secondary MR. We critically discuss the paradigm shift from secondary to tertiary MR and question the notion that MV leaflets play a passive role in secondary MR. We also review the role of standard transthoracic echocardiography for appraising and quantifying maladaptive MV leaflet changes and LV volumes and call for a more sophisticated and comprehensive imaging framework for classifying MR in future interventional studies.
Keywords
Echocardiography, Heart Ventricles/diagnostic imaging, Humans, Mitral Valve Insufficiency/diagnostic imaging, edge-to-edge mitral valve repair, mitral valve leaflets, proportionate mitral valve regurgitation, secondary mitral regurgitation
Pubmed
Web of science
Create date
29/05/2021 15:09
Last modification date
13/01/2024 7:09