Secondary mitral regurgitation (part 1): volumetric quantification and analysis
Secondary mitral regurgitation (MR) develops as a consequence of left ventricular (LV) dilatation and dysfunction, which complicates its evaluation and management. The goal of this article is to review the assessment of secondary MR with special emphasis on quantification and analysis of LV volume d...
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Published in | Heart (British Cardiac Society) Vol. 104; no. 8; pp. 634 - 638 |
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Abstract | Secondary mitral regurgitation (MR) develops as a consequence of left ventricular (LV) dilatation and dysfunction, which complicates its evaluation and management. The goal of this article is to review the assessment of secondary MR with special emphasis on quantification and analysis of LV volume data. At the present time, the optimal method for making these measurements appears to be cardiac MRI. In severe MR (both primary and secondary), the regurgitant fraction (RF) exceeds 50%, and as a result, the LV end diastolic volume (EDV) is increased. In secondary MR, the ejection fraction is depressed (generally <40%) and despite an RF >50%, the regurgitant volume (RegV) rarely meets the current published criteria for severe MR (>60 mL). The ratio of the RegV to EDV, which is very low in secondary MR, reflects the effect of the RegV on the ventricle and it may be predictive of the fractional change in LV size that can be expected after correction of MR. Accurate measurement of the volumetric parameters is essential to proper management of patients with secondary MR. |
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AbstractList | Secondary mitral regurgitation (MR) develops as a consequence of left ventricular (LV) dilatation and dysfunction, which complicates its evaluation and management. The goal of this article is to review the assessment of secondary MR with special emphasis on quantification and analysis of LV volume data. At the present time, the optimal method for making these measurements appears to be cardiac MRI. In severe MR (both primary and secondary), the regurgitant fraction (RF) exceeds 50%, and as a result, the LV end diastolic volume (EDV) is increased. In secondary MR, the ejection fraction is depressed (generally <40%) and despite an RF >50%, the regurgitant volume (RegV) rarely meets the current published criteria for severe MR (>60 mL). The ratio of the RegV to EDV, which is very low in secondary MR, reflects the effect of the RegV on the ventricle and it may be predictive of the fractional change in LV size that can be expected after correction of MR. Accurate measurement of the volumetric parameters is essential to proper management of patients with secondary MR. Secondary mitral regurgitation (MR) develops as a consequence of left ventricular (LV) dilatation and dysfunction, which complicates its evaluation and management. The goal of this article is to review the assessment of secondary MR with special emphasis on quantification and analysis of LV volume data. At the present time, the optimal method for making these measurements appears to be cardiac MRI. In severe MR (both primary and secondary), the regurgitant fraction (RF) exceeds 50%, and as a result, the LV end diastolic volume (EDV) is increased. In secondary MR, the ejection fraction is depressed (generally <40%) and despite an RF >50%, the regurgitant volume (RegV) rarely meets the current published criteria for severe MR (>60 mL). The ratio of the RegV to EDV, which is very low in secondary MR, reflects the effect of the RegV on the ventricle and it may be predictive of the fractional change in LV size that can be expected after correction of MR. Accurate measurement of the volumetric parameters is essential to proper management of patients with secondary MR. |
Author | Gaasch, William H Meyer, Theo E |
Author_xml | – sequence: 1 givenname: William H surname: Gaasch fullname: Gaasch, William H email: William.h.gaasch@lahey.org organization: Department of Cardiovascular Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts, USA – sequence: 2 givenname: Theo E surname: Meyer fullname: Meyer, Theo E email: William.h.gaasch@lahey.org organization: Department of Cardiovascular Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts, USA |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28954829$$D View this record in MEDLINE/PubMed |
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Keywords | heart failure cardiac magnetic resonance (CMR) imaging mitral regurgitation echocardiography |
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SubjectTerms | Cardiology Cardiomyopathy Cardiovascular disease Chronic Disease Diastole - physiology Echocardiography - methods Ejection fraction Geometry Heart failure Humans Magnetic Resonance Angiography - methods Mitral Valve Insufficiency - diagnosis Mitral Valve Insufficiency - etiology Mitral Valve Insufficiency - physiopathology NMR Nuclear magnetic resonance Stroke Stroke Volume - physiology Ventricular Dysfunction, Left - complications Ventricular Dysfunction, Left - physiopathology Ventricular Remodeling - physiology |
Title | Secondary mitral regurgitation (part 1): volumetric quantification and analysis |
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