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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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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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The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Left and right atrioventricular coupling: state-of-the-art review.

Andreea Afana1,2,3,4, Julien Hudelo1,2,3,5, Trecy Gonçalves1,2,3,6

  • 1MIRACL.ai Laboratory, Multimodality Imaging for Research and Analysis Core Laboratory and Artificial Intelligence, AP-HP, Paris 75010, France.

European Heart Journal. Cardiovascular Imaging
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PubMed
Summary

Atrioventricular (AV) coupling, the interaction between atria and ventricles, is vital for heart function. The left/right atrioventricular coupling index (LACI/RACI) quantifies this relationship and predicts cardiovascular disease outcomes.

Keywords:
left atrioventricular couplingleft atrioventricular coupling indexprognosisright atrioventricular coupling

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Area of Science:

  • Cardiovascular Physiology
  • Cardiac Imaging
  • Biomarker Development

Background:

  • Atrioventricular (AV) coupling is crucial for efficient cardiac performance, involving coordinated interaction between atria and ventricles.
  • Disruption of AV coupling leads to impaired cardiac filling, abnormal pressure-volume dynamics, and progressive cardiac remodeling.
  • Mechanisms of uncoupling include atrial/ventricular dysfunction and electromechanical desynchrony.

Purpose of the Study:

  • To review current knowledge on left and right AV coupling.
  • To outline physiological and pathophysiological mechanisms of AV uncoupling.
  • To highlight the diagnostic and prognostic role of the left/right atrioventricular coupling index (LACI/RACI).

Main Methods:

  • The left/right atrioventricular coupling index (LACI/RACI) is defined as the ratio of left/right atrial end-diastolic volume to left/right ventricular end-diastolic volume.
  • LACI/RACI can be noninvasively derived using echocardiography, computed tomography, and cardiovascular magnetic resonance.
  • The index has been validated in large population cohorts.

Main Results:

  • LACI/RACI demonstrates independent and incremental prognostic value for heart failure, atrial fibrillation, and mortality.
  • It outperforms isolated atrial or ventricular parameters in predicting outcomes.
  • LACI/RACI captures dynamic cardiac remodeling, serving as a promising biomarker for risk stratification.

Conclusions:

  • LACI/RACI is a valuable tool for assessing and predicting cardiovascular disease.
  • Standardization of LACI/RACI assessment is needed for clinical translation and precision cardiology.
  • This index offers a comprehensive approach to understanding cardiac function beyond isolated chamber analysis.