| Ischemic mitral regurgitation: mechanisms and echocardiographic classification. | |
| | |
MedLine Citation:
|
PMID: 17600766 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Chronic ischemic mitral regurgitation (IMR) is a common complication of myocardial infarction and severely affects cardiovascular mortality and morbidity. Multiple pathophysiologic mechanisms, such as left ventricular (LV) remodeling and dysfunction, annular dilation/dysfunction, and mechanical dyssynchrony, are involved in generating IMR, each of them having different weight. However, the prerequisite to initially creating regurgitation is the presence of local or global LV remodeling that alters the geometrical relationship between the ventricle and valve apparatus. In the wide spectrum of patients with chronic IMR, the assessment of some echocardiographic parameters, such as tethering pattern, leaflet motion, origin and direction of the regurgitant jets, allows one to identify different specific subgroups of patients subjected to different therapeutic approaches. The aim of medical and/or surgical therapy is to ameliorate heart failure symptoms, and improve LV remodeling and function and the intermediate/long-term outcome. The targets of surgical MV repair involve annulus, leaflets, chordae and ventricles. The restricted annuloplasty is the most commonly adopted surgical procedure that improves heart failure symptoms but not survival when compared to medical therapy and is also subject to a high incidence of late failure (approximately 30%). There are some preoperative echocardiographic predictors of failure that include valve (degree of valve remodeling, jet characteristics), ventricular (degree of remodeling, diastolic dysfunction) and surgical factors. |
| | |
Authors:
|
Eustachio Agricola; Michele Oppizzi; Matteo Pisani; Alessandra Meris; Francesco Maisano; Alberto Margonato |
Related Documents
:
|
1627446 - Doppler echocardiography. 12354706 - Will a partial posterior annuloplasty ring prevent acute ischemic mitral regurgitation? 21539436 - Testosterone replacement therapy and cardiovascular risk factors modification. 20876436 - Pathophysiology of tricuspid regurgitation: quantitative doppler echocardiographic asse... 11577836 - Noninvasive prediction of sudden death and sustained ventricular tachycardia after acut... 2123906 - Early coronary reperfusion blunts the procoagulant response of plasminogen activator in... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 9 ISSN: 1532-2114 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2008 Mar |
Date Detail:
|
Created Date: 2008-05-20 Completed Date: 2008-08-12 Revised Date: 2008-08-14 |
Medline Journal Info:
|
Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
|
Languages: eng Pagination: 207-21 Citation Subset: IM |
Affiliation:
|
Division of Non-Invasive Cardiology, San Raffaele Hospital, Milano, Italy. agricola.eustachio@hsr.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Chronic Disease Echocardiography / methods* Echocardiography, Three-Dimensional Humans Mitral Valve Insufficiency / etiology, physiopathology, ultrasonography* Myocardial Infarction / complications*, physiopathology, ultrasonography Myocardial Ischemia / etiology, physiopathology, ultrasonography* Ventricular Dysfunction, Left / complications, physiopathology, ultrasonography Ventricular Remodeling |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Interpretation of an international terminology standard in the development of a logic-based composit...
Next Document: Giant Eustachian valve and left ventricular systolic dysfunction in a patient with non-dilated amylo...