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Related Concept Videos

Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

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Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
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Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Related Experiment Video

Updated: Jul 11, 2026

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
11:50

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Paradoxic decrease in ischemic mitral regurgitation with papillary muscle dysfunction: insights from

E Messas1, J L Guerrero, M D Handschumacher

  • 1Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Circulation
|October 17, 2001
PubMed
Summary

Papillary muscle (PM) dysfunction can paradoxically reduce ischemic mitral regurgitation (MR) by improving leaflet coaptation. This finding highlights geometric factors in MR and suggests new therapeutic approaches.

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Last Updated: Jul 11, 2026

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
11:50

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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

Area of Science:

  • Cardiovascular Physiology
  • Cardiac Mechanics
  • Medical Imaging

Background:

  • Ischemic mitral regurgitation (MR) has been traditionally attributed to papillary muscle (PM) contractile dysfunction.
  • Current theories focus on left ventricular (LV) distortion causing apical leaflet tethering.
  • However, PM dysfunction is still commonly diagnosed, prompting a re-evaluation of its role.

Purpose of the Study:

  • To investigate the hypothesis that PM contractile dysfunction can paradoxically decrease MR.
  • To explore the role of inferior base ischemia in modulating MR through geometric changes.

Main Methods:

  • Occluded proximal circumflex circulation in 7 sheep, maintaining PM perfusion.
  • Measured leaflet tethering distance and LV ejection volume using 3D echocardiography.
  • Assessed MR by subtracting LV outflow from LV ejection volume.

Main Results:

  • Inferior ischemia alone induced mild-to-moderate MR (25.2+/-2.8% regurgitant fraction) due to PM tip retraction.
  • Adding PM ischemia reduced MR (5.2+/-0.3 to 1.4+/-0.3 mL) and tethering distance.
  • PM strain rate shifted from contraction to elongation, decreasing leaflet tenting.

Conclusions:

  • PM contractile dysfunction can paradoxically decrease MR in inferobasal ischemia.
  • This effect is mediated by reduced leaflet tethering and improved coaptation.
  • Geometric factors are crucial in ischemic MR mechanisms and potential therapeutic strategies.