Multimodality Imaging in Secondary Mitral Regurgitation.
Harish Sharma1,2, Boyang Liu2, Hani Mahmoud-Elsayed2,3
1Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Frontiers in Cardiovascular Medicine
|January 8, 2021
Summary
Secondary mitral regurgitation (sMR), often linked to heart conditions like cardiomyopathy, increases mortality risk. The COAPT trial showed transcatheter mitral valve repair improves survival, highlighting the need for better patient selection.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Interventional Cardiology
Background:
- Secondary mitral regurgitation (sMR) stems from left ventricular (LV) dilation or dysfunction, complicating cardiomyopathies.
- Ischemic cardiomyopathy is a leading cause of sMR, independently predicting mortality and heart failure hospitalizations.
- Current guidelines lack consensus on sMR intervention thresholds, despite its adverse outcomes.
Purpose of the Study:
- To review the role of multimodality imaging in diagnosing, quantifying, and risk-stratifying patients with sMR.
- To discuss the impact of the COAPT trial on the management of sMR.
- To highlight the importance of identifying patients who may benefit from mitral valve intervention.
Main Methods:
- Review of current literature and clinical guidelines.
- Analysis of findings from the COAPT trial.
- Discussion of the utility of echocardiography and cardiovascular magnetic resonance (CMR).
Main Results:
- Severe sMR is an independent predictor of mortality and heart failure hospitalizations.
- The COAPT trial demonstrated a mortality benefit from transcatheter mitral valve repair for sMR.
- Multimodality imaging is crucial for patient management and intervention planning.
Conclusions:
- Transcatheter mitral valve repair shows promise for improving outcomes in select sMR patients.
- Accurate diagnosis and risk stratification using imaging are essential for guiding treatment decisions.
- Further research and consensus are needed to optimize the management of sMR.
Keywords:
computed tomographyechocardiogaphyischaemic heart diseasemagnetic resonanace imagingmitral regurgitationMore Related Videos
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
89
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
89
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
143
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...
143
01:20Mitral Regurgitation I: Introduction
177
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...
177
01:25Mitral Regurgitation III: Medical Management
126
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...
126
01:28Mitral Regurgitation IV: Nursing Management
193
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
193
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
203
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
203