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Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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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...
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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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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...
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Chambers of the Heart01:16

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The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
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Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

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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...
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Changes in left atrial structure and function over a decade in the general population.

Flemming Javier Olsen1,2, Niklas Dyrby Johansen1,2, Kristoffer Grundtvig Skaarup1,2

  • 1The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.

European Heart Journal. Cardiovascular Imaging
|September 1, 2021
PubMed
Summary

Left atrial (LA) volume increases over time, accelerated by age and atrial fibrillation (AF). This LA remodelling significantly elevates the risk for developing AF and heart failure (HF).

Keywords:
echocardiographyleft atriumlongitudinalremodelling

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Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Imaging

Background:

  • Left atrial (LA) size and function are crucial echocardiographic parameters.
  • Understanding the longitudinal changes and drivers of LA remodelling is essential for predicting cardiovascular outcomes.

Purpose of the Study:

  • To investigate the temporal changes in LA size and function.
  • To identify clinical and echocardiographic factors that accelerate LA remodelling.
  • To assess the predictive value of LA remodelling for incident atrial fibrillation (AF) and heart failure (HF).

Main Methods:

  • Longitudinal analysis of LA volume (maximal and minimal) and emptying fraction in 1065 participants from the Copenhagen City Heart Study over a median of 10.4 years.
  • Linear regression to identify clinical and echocardiographic accelerators of LA remodelling.
  • Cox proportional hazards regression to evaluate the association between LA remodelling and incident AF/HF.

Main Results:

  • Maximal and minimal LA volumes significantly increased over time (8.3 and 3.5 mL/m2, respectively), while LA emptying fraction remained unchanged.
  • Age and AF were identified as key clinical accelerators of LA remodelling.
  • Left ventricular (LV) systolic function, diameter, and mass also significantly accelerated LA remodelling.
  • Increases in both maximal and minimal LA volumes were significantly associated with increased risk of incident AF and HF.

Conclusions:

  • Left atrial volume demonstrably increases over time, indicating progressive atrial remodelling.
  • Clinical factors such as age and atrial fibrillation, along with left ventricular characteristics, are significant drivers of this remodelling.
  • The degree of left atrial remodelling is a significant predictor of adverse clinical outcomes, including atrial fibrillation and heart failure.