Abstract
Functional mitral regurgitation is the consequence of left ventricular systolic dysfunction in the presence of an anatomically normal mitral valve. Systolic left ventricular failure is often the cause of congestive heart failure, which is a frequent reason for admission to the intensive care unit (ICU). The most frequent cause of left ventricular dysfunction is ischemic heart disease. Both the ventricle and the mitral valve apparatus are involved in the pathogenesis of functional mitral regurgitation. The mitral valve is a complex apparatus, composed of the mitral valve leaflets, the chordae tendineae, papillary muscles, and the related regional area of the ventricular wall (Fig. 1). Malfunction of one or more components of this apparatus engenders improper functioning of the mitral valve.
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Keywords
- Mitral Valve
- Mitral Regurgitation
- Papillary Muscle
- Functional Mitral Regurgitation
- Ischemic Mitral Regurgitation
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References
Cohn LH, Kowalker W, Bhatia S, et al (1988) Comparative morbidity of mitral valve repair versus replacement for mitral regurgitation with and without coronary artery disease. Ann Thorac Surg 45: 284–290
Gomez-Doblas JJ, Schor J, Vignola P, et al (2001) Left ventricular geometry and operative mortality in patients undergoing mitral valve replacement. Clin Cardiol 24: 717–722
Lamas GA, Mitchell GF, Flaker GC, et al (1997) Clinical significance of mitral regurgitation after acute myocardial infarction. Survival and Ventricular Enlargement Investigators. Circulation 96: 827–833
Lee R, Haluska B, Leung DY, Case C, Mundy J, Marwick TH (2005) Functional and prognostic implications of left ventricular contractile reserve in patients with asymptomatic severe mitral regurgitation. Heart 91: 1407–1412
Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, et al (2005) Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med 352: 875–883
Bursi F, Enriquez-Sarano M, Nkomo VT, et al (2005) Heart failure and death after myocardial infarction in the community: the emerging role of mitral regurgitation. Circulation 111: 295–301
Taams MA, Gussenhoven EJ, Cahalan MK, et al (1989) Transesophageal Doppler color flow imaging in the detection of native and Bjork-Shiley mitral valve regurgitation. J Am Coll Cardiol 13: 95–99
Carpentier A, Chauvaud S, Fabiani JN, et al (1980) Reconstructive surgery of mitral valve incompetence: ten-year appraisal. J Thorac Cardiovasc Surg 79: 338–348
Nwasokwa O, Camesas A, Weg I, Bodenheimer MM (1989) Differences in left ventricular adaptation to chronic mitral and aortic regurgitation. Chest 95: 106–110
Yiu SF, Enriquez-Sarano M, Tribouilloy C, Seward JB, Tajik AJ (2000) Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: A quantitative clinical study. Circulation 102: 1400–1406
Yoshida K, Yoshikawa J, Yamaura Y, et al (1990) Value of acceleration flows and regurgitant jet direction by color Doppler flow mapping in the evaluation of mitral valve prolapse. Circulation 81: 879–885
Hung J, Papakostas L, Tahta SA, et al (2004) Mechanism of recurrent ischemic mitral regurgitation after annuloplasty: continued LV remodeling as a moving target. Circulation 110: II85–90
Poelaert J, Schmidt C, Colardyn F (1998) Transoesophageal echocardiography in the critically ill. Anaesthesia 53: 55–68
Poelaert JI, Schupfer G (2005) Hemodynamic monitoring utilizing transesophageal echocardiography: The relationships among pressure, flow, and function. Chest 127: 379–390
Otsuji Y, Handschumacher MD, Schwammenthal E, et al (1997) Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation 96: 1999–2008
Edvardsen T, Urheim S, Skulstad H, Steine K, Ihlen H, Smiseth OA (2002) Quantification of left ventricular systolic function by tissue doppler echocardiography: Added value of measuring pre-and postejection velocities in ischemic myocardium. Circulation 105: 2071–2077
Amà R, Segers P, Roosens C, Claessens T, Verdonck P, Poelaert J (2004) Effects of load on systolic mitral annular velocity by tissue Doppler imaging. Anesth Analg 99: 332–338
Berger M, Haimowitz A, Van Tosh A, Berdoff R, Goldberg E (1985) Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol 6: 359–365
Quiles J, Garcia-Fernandez MA, Almeida PB, et al (2003) Portable spectral Doppler echocardiographic device: overcoming limitations. Heart 89: 1014–1018
Dini FL, Conti U, Fontanive P, et al (2007) Right ventricular dysfunction is a major predictor of outcome in patients with moderate to severe mitral regurgitation and left ventricular dysfunction. Am Heart J 154: 172–179
Aklog L, Filsoufi F, Flores KQ, et al (2001) Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation 104:I68–75
Czer LS, Maurer G, Bolger AF, DeRobertis M, Chaux A, Matloff JM (1996) Revascularization alone or combined with suture annuloplasty for ischemic mitral regurgitation. Evaluation by color Doppler echocardiography. Tex Heart Inst J 23: 270–278
Bach D, Deeb M, Bolling S (1995) Accuracy of intraoperative transesophageal echocardiography for estimating the severity of functional mitral regurgitation. Am J Cardiol 76: 508–512
Bolling SF (2002) Mitral reconstruction in cardiomyopathy. J Heart Valve Dis 11 (Suppl 1): S26–31
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Poelaert, J. (2009). Functional Mitral Regurgitation in the Critically Ill. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92278-2_51
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DOI: https://doi.org/10.1007/978-0-387-92278-2_51
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