| Eclipsed mitral regurgitation: a new form of functional mitral regurgitation for an unusual cause of heart failure with normal ejection fraction. | |
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MedLine Citation:
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PMID: 17934266 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Transient functional mitral regurgitation (MR) has never been reported as a cause of heart failure (HF) with normal ejection fraction (EF) in the absence of epicardial coronary artery stenosis. RESULTS: Performance of echocardiography in patients with acute HF before initiation of HF medical treatment allowed identification of three patients with normal EF but transient massive functional MR during the HF episode. In all patients, massive MR occurred as a consequence of sudden extreme apical tenting of both leaflets with total lack of coaptation, despite normal EF and absence of detectable left ventricular (LV) remodeling, and despite absence of significant stenosis on coronary arteries. In all patients MR was triggered by methylergonovine injection and was reversible either spontaneously or after nitroglycerine administration, leaving patients with normal echocardiogram between HF episodes. In two patients, long-term administration of calcium channel blockers prevented recurrences of MR and HF, whereas in one, mitral valve was eventually replaced. CONCLUSION: Sudden reversible apical tenting of mitral leaflets with subsequent torrential MR and acute HF can occur despite normal EF, absence of pre-existing LV remodeling and absence of coronary artery stenosis. This atypical type of functional MR is an unusual mechanism of HF in patients with normal LVEF. |
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Authors:
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Jean-François Avierinos; Franck Thuny; Laurence Tafanelli; Sebastien Renard; Virginie Chalvignac; Eric Guedj; Marc Lambert; Jacques Quilici; Jean-Louis Bonnet; Maurice Enriquez-Sarano; Gilbert Habib |
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Publication Detail:
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Type: Journal Article Date: 2007-10-10 |
Journal Detail:
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Title: Cardiology Volume: 110 ISSN: 1421-9751 ISO Abbreviation: Cardiology Publication Date: 2008 |
Date Detail:
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Created Date: 2008-04-02 Completed Date: 2008-04-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 29-34 Citation Subset: IM |
Affiliation:
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Cardiology Department, Timone Hospital, Marseille, France. jfavierinos@ap-hm.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Combined Modality Therapy Coronary Angiography Echocardiography, Doppler Electrocardiography Female Heart Failure / etiology*, physiopathology, therapy Humans Male Mitral Valve Insufficiency / complications*, diagnosis*, drug therapy Prognosis Radionuclide Imaging / methods Reference Values Risk Assessment Sampling Studies Severity of Illness Index Stroke Volume / physiology* Thallium Thallium Radioisotopes / diagnostic use Ventricular Remodeling / physiology |
| Chemical | |
Reg. No./Substance:
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0/Thallium Radioisotopes; 7440-28-0/Thallium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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