Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation

6533b7d4fe1ef96bd1261f16

RESEARCH PRODUCT

Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation

Eustachio Agricola Roberta Montisci Alberto Margonato Marco Spartera Sabina Gallina Matteo Cameli Donato Mele Roberta Esposito Giuseppina Novo Antonello D'andrea Sergio Mondillo Andrea Rossi Flavio D'ascenzi Maurizio Galderisi

subject

medicine.medical_specialty Pacemaker Artificial medicine.medical_treatment Cardiac resynchronization therapy Ventricular dyssynchrony 030204 cardiovascular system & hematology Cardiac resynchronization; Mitral regurgitation; Ventricular dyssynchrony; Cardiology and Cardiovascular Medicine; Radiology Nuclear Medicine and Imaging Ventricular Function Left Cardiac Resynchronization Therapy 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine Internal medicine Cardiac resynchronization Nuclear Medicine and Imaging medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Ventricular remodeling Ventricular dyssynchrony Mitral regurgitation Mitral regurgitation Clinical Trials as Topic Ventricular Remodeling business.industry Cardiac Pacing Artificial Mitral Valve Insufficiency Stroke Volume General Medicine Stroke volume medicine.disease Prognosis Review article Echocardiography Doppler Color Clinical trial medicine.anatomical_structure Treatment Outcome Ventricle cardiovascular system Cardiology Radiology business Cardiology and Cardiovascular Medicine Radiology

description

Functional mitral regurgitation (FMR) is a common complication of left ventricle (LV) dysfunction and remodelling. Recently, it has been recognized as an independent prognostic factor in both ischaemic and non-ischaemic LV dysfunctions. In this review article, we discuss the mechanisms through which cardiac dyssynchrony is involved in FMR pathophysiologic cascade and how cardiac resynchronization therapy (CRT) can have therapeutic effects on FMR by reverting specific dyssynchrony pathways. We analyse recent clinical trials focusing on CRT impact on FMR in 'real-world' patients, the limits and future perspectives that could eventually generate new predictors of CRT response in terms of FMR reduction. Finally, we propose a practical diagnostic and therapeutic strategy for the management of symptomatic patients with severe LV dysfunction and concomitant 'prognostic' FMR.

year	journal	country	edition	language
2016-01-01

10.1093/ehjci/jev352 http://hdl.handle.net/11365/998814