Pathophysiology, Echocardiographic Diagnosis, and Treatment of Atrial Functional Mitral Regurgitation

被引：32

作者：

Farhan, Serdar ^{[1
]}

Silbiger, Jeffrey J. ^{[1
,2
]}

Halperin, Jonathan L. ^{[1
]}

Zhang, Lily ^{[1
]}

Dukkipati, Srinivas R. ^{[1
]}

Vogel, Birgit ^{[1
]}

Kini, Annapoorna ^{[1
]}

Sharma, Samin ^{[1
]}

Lerakis, Stamatios ^{[1
]}

机构：

[1] Mt Sinai Hosp, Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, One Gustave L Levy Pl, New York, NY 10029 USA

[2] Elmhurst Hosp Ctr, Icahn Sch Med Mt Sinai, Dept Cardiol, 79-01 Broadway,Room D3-24C, Elmhurst, NY 11373 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2022年 / 80卷 / 24期

关键词：

atrial fibrillation; atrial functional mitral regurgitation; atrial functional tricuspid regurgitation; atriogenic leaflet tethering; hamstringing; mitral annulus; TRICUSPID REGURGITATION; MECHANISTIC INSIGHTS; HEART-FAILURE; VALVE ANNULOPLASTY; CATHETER ABLATION; FIBRILLATION; GEOMETRY; OUTCOMES; ASSOCIATION; ADAPTATION;

D O I：

10.1016/j.jacc.2022.09.046

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The conventional view holds that functional mitral regurgitation (MR) is caused by restriction of leaflet motion resulting from displacement of the papillary muscle-bearing segments of the left ventricle. In the past decade, evidence has accrued suggesting functional MR can also be caused by left atrial enlargement. This underrecognized cause of secondary MR-atrial functional MR (AF-MR)-is mechanistically linked to annular enlargement, perturbations of annular contraction, and atriogenic leaflet tethering. AF-MR has been described in patients with atrial fibrillation and heart failure with preserved ejection fraction. Preliminary data suggest rhythm control may decrease MR severity in patients with atrial fibrillation. Additionally, several studies have reported reductions in MR and symptomatic improvement with restrictive annuloplasty and transcatheter edge-to-edge repair. This review discusses the pathophysiology, echocardiographic diagnosis, and treatment of AF-MR. AF-tricuspid regurgitation is also discussed. (c) 2022 by the American College of Cardiology Foundation.

引用

页码：2314 / 2330

页数：17

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