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Proportionate or disproportionate secondary mitral regurgitation: how to untangle the Gordian knot?
- Source :
- Heart (British Cardiac Society). 106(22)
- Publication Year :
- 2020
-
Abstract
- Recent randomised percutaneous mitral intervention trials in patients with heart failure with secondary mitral regurgitation (SMR) have yielded contrasting results. A ‘relative load’ or ‘proportionality’ conceptual framework for SMR has been proposed to partly explain the disparate results. The rationale behind the framework is that SMR depends on the left ventricular dimension and not vice versa. In this review, we provide an in-depth analysis of the proportionality parameters used in this framework and also discuss the regurgitant fraction. We also consider haemodynamic observations in SMR that may affect the interpretation and comparisons among proportionality parameters. The conclusion is that the proportionality concept remains hypothetical and requires prospective validation before envisaging its use at individual patient level for risk stratification or therapeutic decision-making.
- Subjects :
- medicine.medical_specialty
Mitral regurgitation
Intervention trials
business.industry
Heart Ventricles
Hemodynamics
Mitral Valve Insufficiency
Severity of Illness Index
Internal medicine
Risk stratification
Regurgitant fraction
Cardiology
Quantitative assessment
Medicine
Humans
Mitral Valve
In patient
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1468201X
- Volume :
- 106
- Issue :
- 22
- Database :
- OpenAIRE
- Journal :
- Heart (British Cardiac Society)
- Accession number :
- edsair.doi.dedup.....7933a3d0f66b180c8a6f2e9c450c1bf8