Pathophysiology, Echocardiographic Diagnosis, and Treatment of Atrial Functional Mitral Regurgitation: JACC State-of-the-Art Review
The conventional view holds that functional mitral regurgitation (MR) is caused by restriction of leaflet motion resulting from displacement of the papillary muscle-bearing segments of the left ventricle. In the past decade, evidence has accrued suggesting functional MR can also be caused by left at...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2022-12, Vol.80 (24), p.2314-2330 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Farhan, Serdar Silbiger, Jeffrey J Halperin, Jonathan L Zhang, Lily Dukkipati, Srinivas R Vogel, Birgit Kini, Annapoorna Sharma, Samin Lerakis, Stamatios |
| description | The conventional view holds that functional mitral regurgitation (MR) is caused by restriction of leaflet motion resulting from displacement of the papillary muscle-bearing segments of the left ventricle. In the past decade, evidence has accrued suggesting functional MR can also be caused by left atrial enlargement. This underrecognized cause of secondary MR-atrial functional MR (AF-MR)-is mechanistically linked to annular enlargement, perturbations of annular contraction, and atriogenic leaflet tethering. AF-MR has been described in patients with atrial fibrillation and heart failure with preserved ejection fraction. Preliminary data suggest rhythm control may decrease MR severity in patients with atrial fibrillation. Additionally, several studies have reported reductions in MR and symptomatic improvement with restrictive annuloplasty and transcatheter edge-to-edge repair. This review discusses the pathophysiology, echocardiographic diagnosis, and treatment of AF-MR. AF-tricuspid regurgitation is also discussed. |
| doi_str_mv | 10.1016/j.jacc.2022.09.046 |
| format | Article |
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In the past decade, evidence has accrued suggesting functional MR can also be caused by left atrial enlargement. This underrecognized cause of secondary MR-atrial functional MR (AF-MR)-is mechanistically linked to annular enlargement, perturbations of annular contraction, and atriogenic leaflet tethering. AF-MR has been described in patients with atrial fibrillation and heart failure with preserved ejection fraction. Preliminary data suggest rhythm control may decrease MR severity in patients with atrial fibrillation. Additionally, several studies have reported reductions in MR and symptomatic improvement with restrictive annuloplasty and transcatheter edge-to-edge repair. This review discusses the pathophysiology, echocardiographic diagnosis, and treatment of AF-MR. AF-tricuspid regurgitation is also discussed.</description><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2022.09.046</identifier><identifier>PMID: 36480974</identifier><language>eng</language><publisher>United States</publisher><subject>Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - surgery ; Humans ; Plastic Surgery Procedures</subject><ispartof>Journal of the American College of Cardiology, 2022-12, Vol.80 (24), p.2314-2330</ispartof><rights>Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. 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AF-tricuspid regurgitation is also discussed.</description><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - surgery</subject><subject>Humans</subject><subject>Plastic Surgery Procedures</subject><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kE1PgzAAhhsT4-b0D3gwPXoY2A8o4G2Zmx-Z0ejupJQWugDFtmh29o_L4jy9H3nyHl4ArjAKMcLsdhfuuBAhQYSEKAtRxE7AFMdxGtA4Sybg3LkdQoilODsDE8qiFGVJNAU_b9zXpq_3TpvGVPs5XInaCG5LbSrL-1oLeK951Rmn3RzyroRbK7lvZeehUXDhreYNXA-d8Np0o33R3o7yLqvBVtrzQ30HnxfLJfwYkwyMCnwtg4X1I_Sl5fcFOFW8cfLyqDOwXa-2y8dg8_rwtFxsgh4T5oOCKZHIOCNJQlJKGE7SLI64UgmjOGJliWUZiYLyFKFMUYIPSFkoJQiTaUFn4OZvtrfmc5DO5612QjYN76QZXE6SmJIMM0pH9PqIDkUry7y3uuV2n___Rn8B88tv8A</recordid><startdate>20221213</startdate><enddate>20221213</enddate><creator>Farhan, Serdar</creator><creator>Silbiger, Jeffrey J</creator><creator>Halperin, Jonathan L</creator><creator>Zhang, Lily</creator><creator>Dukkipati, Srinivas R</creator><creator>Vogel, Birgit</creator><creator>Kini, Annapoorna</creator><creator>Sharma, Samin</creator><creator>Lerakis, Stamatios</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20221213</creationdate><title>Pathophysiology, Echocardiographic Diagnosis, and Treatment of Atrial Functional Mitral Regurgitation: JACC State-of-the-Art Review</title><author>Farhan, Serdar ; Silbiger, Jeffrey J ; Halperin, Jonathan L ; Zhang, Lily ; Dukkipati, Srinivas R ; Vogel, Birgit ; Kini, Annapoorna ; Sharma, Samin ; Lerakis, Stamatios</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p126t-b6fc7e5927728326178954aff763146dd1ed4cb3a8009f3212617dbffc26e8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - surgery</topic><topic>Humans</topic><topic>Plastic Surgery Procedures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farhan, Serdar</creatorcontrib><creatorcontrib>Silbiger, Jeffrey J</creatorcontrib><creatorcontrib>Halperin, Jonathan L</creatorcontrib><creatorcontrib>Zhang, Lily</creatorcontrib><creatorcontrib>Dukkipati, Srinivas R</creatorcontrib><creatorcontrib>Vogel, Birgit</creatorcontrib><creatorcontrib>Kini, Annapoorna</creatorcontrib><creatorcontrib>Sharma, Samin</creatorcontrib><creatorcontrib>Lerakis, Stamatios</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farhan, Serdar</au><au>Silbiger, Jeffrey J</au><au>Halperin, Jonathan L</au><au>Zhang, Lily</au><au>Dukkipati, Srinivas R</au><au>Vogel, Birgit</au><au>Kini, Annapoorna</au><au>Sharma, Samin</au><au>Lerakis, Stamatios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pathophysiology, Echocardiographic Diagnosis, and Treatment of Atrial Functional Mitral Regurgitation: JACC State-of-the-Art Review</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2022-12-13</date><risdate>2022</risdate><volume>80</volume><issue>24</issue><spage>2314</spage><epage>2330</epage><pages>2314-2330</pages><eissn>1558-3597</eissn><abstract>The conventional view holds that functional mitral regurgitation (MR) is caused by restriction of leaflet motion resulting from displacement of the papillary muscle-bearing segments of the left ventricle. 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| ispartof | Journal of the American College of Cardiology, 2022-12, Vol.80 (24), p.2314-2330 |
| issn | 1558-3597 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - surgery Humans Plastic Surgery Procedures |
| title | Pathophysiology, Echocardiographic Diagnosis, and Treatment of Atrial Functional Mitral Regurgitation: JACC State-of-the-Art Review |
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