Mitral valve disease--morphology and mechanisms.
Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but--even in adult life--remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular-ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of mitral valve disease.
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey 5E, Boston, MA 02114, USA.
Robert A
RA
Levine
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Albert A
AA
Hagége
Johns Hopkins University, Baltimore, MD, USA.
Daniel P
DP
Judge
Emory University School of Medicine, Atlanta, GA, USA.
Muralidhar
M
Padala
Massachusetts General Hospital, Cardiac Ultrasound Laboratory, Harvard Medical School, Boston, MA, USA.
Jacob P
JP
Dal-Bianco
Brigham and Women's Hospital, Boston, MA, USA.
Elena
E
Aikawa
Laval Hospital, Quebec City, Canada.
Jonathan
J
Beaudoin
Boston Children's Hospital, Boston, MA, USA.
Joyce
J
Bischoff
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Nabila
N
Bouatia-Naji
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Patrick
P
Bruneval
Cornell University, Ithaca, NY, USA.
Jonathan T
JT
Butcher
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Alain
A
Carpentier
University of Montreal, Montreal, Canada.
Miguel
M
Chaput
Imperial College London, London, UK.
Adrian H
AH
Chester
INSERM-Transfert, Paris, France.
Catherine
C
Clusel
Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA.
Francesca N
FN
Delling
Johns Hopkins University, Baltimore, MD, USA.
Harry C
HC
Dietz
University of Nantes, Thoracic Institute, INSERM UMR 1097, CNRS UMR 6291, Nantes, France.
Christian
C
Dina
Hadassah-Hebrew University Medical Centre, Jerusalem, Israel.
Ronen
R
Durst
Hospital Universitario HM Monteprincipe and the Centro Nacional de Investigaciones Cardiovasculares, Carlos III (CNIC), Madrid, Spain.
Leticia
L
Fernandez-Friera
Massachusetts General Hospital, Cardiac Ultrasound Laboratory, Harvard Medical School, Boston, MA, USA.
Mark D
MD
Handschumacher
University of Aarhus, Aarhus, Denmark.
Morten O
MO
Jensen
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Xavier P
XP
Jeunemaitre
University of Nantes, Thoracic Institute, INSERM UMR 1097, CNRS UMR 6291, Nantes, France.
Hervé
H
Le Marec
University of Nantes, Thoracic Institute, INSERM UMR 1097, CNRS UMR 6291, Nantes, France.
Thierry
T
Le Tourneau
Medical University of South Carolina, Charleston, SC, USA.
Roger R
RR
Markwald
University of Nantes, Thoracic Institute, INSERM UMR 1097, CNRS UMR 6291, Nantes, France.
Jean
J
Mérot
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Emmanuel
E
Messas
Cardiovascular Research Center, Harvard Medical School, Boston, MA, USA.
David P
DP
Milan
Aix-Marseille University, INSERM UMR 910, Marseille, France.
Tui
T
Neri
Medical University of South Carolina, Charleston, SC, USA.
Russell A
RA
Norris
Cardiovascular Research Center, Harvard Medical School, Boston, MA, USA.
David
D
Peal
Hôpital Européen Georges Pompidou, Université René Descartes, UMR 970, Paris, France.
Maelle
M
Perrocheau
University of Nantes, Thoracic Institute, INSERM UMR 1097, CNRS UMR 6291, Nantes, France.
Vincent
V
Probst
Aix-Marseille University, INSERM UMR 910, Marseille, France.
Michael
M
Pucéat
European Molecular Biology Laboratory, Monterotondo, Italy.
Nadia
N
Rosenthal
Hospital Universitario HM Monteprincipe and the Centro Nacional de Investigaciones Cardiovasculares, Carlos III (CNIC), Madrid, Spain.
Jorge
J
Solis
University of Nantes, Thoracic Institute, INSERM UMR 1097, CNRS UMR 6291, Nantes, France.
Jean-Jacques
JJ
Schott
Tel Aviv University, Tel Aviv, Israel.
Ehud
E
Schwammenthal
Center for Human Genetic Research, MGH Research Institute, Harvard Medical School, Boston, MA, USA.
Susan A
SA
Slaugenhaupt
Asan Medical Centre, Seoul, South Korea.
Jae-Kwan
JK
Song
Imperial College London, London, UK.
Magdi H
MH
Yacoub
D006801:Humans; D008944:Mitral Valve Insufficiency