Functional mitral regurgitation and chronic heart failure.
Functional mitral regurgitation (MR) frequently develops during the progression of chronic heart failure and predicts poor outcome. Impaired left ventricular (LV) function, LV remodeling associated with papillary muscle apical displacement and annular enlargement result in decreased mitral closing forces and tenting of the mitral valve at closure. Reduced closing forces and tenting both promote MR. Active myocardial ischemia, myocardial asynchronism and excessive loading conditions worsen MR at rest and during exercise. The therapeutic target in functional MR is the left ventricle and not the valve.
Ennezat
P V
PV
Cardiology Hospital, Lille, France. enezat@yahoo.com
Marechaux
S
S
Asseman
P
P
Lejemtel
T H
TH
Van Belle
E
E
Bauters
C
C
De Groote
P
P
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000465:Algorithms; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D018618:Echocardiography, Doppler, Color; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008943:Mitral Valve / Q000473:pathology; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D011379:Prognosis; D018487:Ventricular Dysfunction, Left
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors