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http://hdl.handle.net/1942/28292
Title: | Atrial Functional Mitral Regurgitation | Authors: | DEFERM, Sebastien BERTRAND, Philippe VERBRUGGE, Frederik Verhaert, David Rega, Filip Thomas, James D. VANDERVOORT, Pieter |
Issue Date: | 2019 | Source: | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 73(19), p. 2465-2476 | Abstract: | Unlike secondary mitral regurgitation (MR) in the setting of left ventricular (LV) disease, the occurrence of functional MR in atrial fibrillation (AF) and/or heart failure with preserved ejection fraction (HFpEF) has remained largely unspoken. LV size and systolic function are typically normal, whereas isolated mitral annular dilation and inadequate leaflet adaptation are considered mechanistic culprits. Moreover, the role of left atrial and annular dynamics in provoking MR is often underappreciated. Because of this peculiar pathophysiology, atrial functional MR benefits from a different approach compared with secondary MR. Although both AF and HFpEF—two closely related disease epidemics of the 21st century—are held responsible, current guidelines do not emphasize the need to differentiate atrial functional MR from (ventricular) secondary MR. This review summarizes the prevalence and prognostic importance of atrial functional MR, providing mechanistic insights compared with those of secondary MR and suggesting potential therapeutic targets. | Notes: | Vandervoort, PM (reprint author), Hosp Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. pieter.vandervoort@zol.be | Keywords: | atrial fibrillation; functional mitral regurgitation; heart failure with preserved ejection fraction; mitral annular dilatation; mitral annulus; secondary mitral regurgitation | Document URI: | http://hdl.handle.net/1942/28292 | ISSN: | 0735-1097 | e-ISSN: | 1558-3597 | DOI: | 10.1016/j.jacc.2019.02.061 | ISI #: | 000467710400014 | Rights: | 2019 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY ELSEVIER | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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10.1016@j.jacc.2019.02.061.pdf Restricted Access | Published version | 2.94 MB | Adobe PDF | View/Open Request a copy |
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