Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation

被引：50

作者：

Spartera, Marco ^{[1
]}

Galderisi, Maurizio ^{[2
]}

Mele, Donato ^{[3
]}

Cameli, Matteo ^{[4
]}

D'Andrea, Antonello ^{[5
]}

Rossi, Andrea ^{[6
]}

Mondillo, Sergio ^{[4
]}

Novo, Giuseppina ^{[7
]}

Esposito, Roberta ^{[2
]}

D'Ascenzi, Flavio ^{[4
]}

Montisci, Roberta ^{[8
]}

Gallina, Sabina ^{[9
]}

Margonato, Alberto ^{[1
]}

Agricola, Eustachio ^{[1
]}

机构：

[1] Hosp San Raffaele, IRCCS, Cardiovasc Dept, Div Cardiol, Via Olgettina 60, I-20132 Milan, Italy

[2] Federico II Univ Hosp, Dept Adv Biomed Sci, Naples, Italy

[3] Univ Ferrara, Dept Cardiol, I-44100 Ferrara, Italy

[4] Univ Siena, Dept Cardiovasc Dis, Via Laterina 8, I-53100 Siena, Italy

[5] Univ Naples 2, dei Colli Monaldi Hosp, Dept Cardiol, Naples, Italy

[6] Univ Verona, Cardiol Sect, Dept Med, I-37100 Verona, Italy

[7] Univ Hosp Paolo Giaccone, Dept Cardiol, Palermo, Italy

[8] Univ Cagliari, Clin Cardiol, Cagliari, Italy

[9] Univ G DAnnunzio, Div Cardiol, S Camillo de Lellis Hosp, Chieti, Italy

来源：

EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING | 2016年 / 17卷 / 05期

关键词：

cardiac resynchronization; mitral regurgitation; ventricular dyssynchrony; IDIOPATHIC DILATED CARDIOMYOPATHY; HEART-FAILURE; VENTRICULAR DYSSYNCHRONY; STRESS ECHOCARDIOGRAPHY; MECHANISM; REDUCTION; MORTALITY; EXERCISE; INSIGHTS; IMPACT;

D O I：

10.1093/ehjci/jev352

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：471 / 480

页数：10

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