title: [Valvular surgery for an exercise-induced functional mitral regurgitation in heart failure and preserved ejection fraction: a case study].
abstract: We here report the case of a 67-year-old woman with moderate mitral regurgitation without significant structural abnormalities that get worse during severe recurrent heart failures and preserved ejection fraction with concomitant paroxysmal atrial fibrillation. Atrial fibrillation became permanent and despite a well-controlled cardiac frequency, new heart failure episodes occurred. Exercise doppler echocardiography showed that the mechanism of this mitral regurgitation was a two leaflet mitral tenting. We discuss here the different mechanisms that could induce these kinds of mitral regurgitation with excessive tenting. We emphasize the interest of early detection by exercise doppler echocardiography even when a triggering factor like atrial fibrillation seems to be involved. We also discuss the interest of mitral valve replacement for these patients.
authors.affiliation: Pôle Neurocardiologie, centre hospitalier du Mans, 194, avenue Rubillard, 72037 Le Mans cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Attari
authors.forename: M
authors.initials: M
authors.lastname: Legrand
authors.forename: C
authors.initials: C
authors.lastname: Philippe
authors.forename: P
authors.initials: P
authors.lastname: Rosak
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology; D018450:Disease Progression; D042241:Early Diagnosis; D025401:Echocardiography, Stress; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume