Functional mitral regurgitation: are we treating the real target?

Giovanni Benfari, Rajesh Dandale, Andrea Rossi, Francesco Onorati, Giacomo Mugnai, Flavio Ribichini, Pier L. Temporelli, Corrado Vassanelli

Research output: Contribution to journalArticle

Abstract

Functional mitral regurgitation is a form of valve insufficiency in the presence of anatomically normal mitral valve. The cause of functional mitral regurgitation is left ventricular remodelling that tethers valve leaflet more apically decreasing their coaptation ability. Given the pathophysiologic relation between functional mitral regurgitation and ventricular dysfunction, the valve insufficiency has long been considered a surrogate of ventricular disease. Accordingly, all potential therapeutic strategies able to decrease functional mitral regurgitation have been associated with improved ventricular function. On the contrary, the surgical treatment of functional mitral regurgitation has led to contrasting results, but the main drawback is that it does not improve survival compared with medical therapy. However, surgery is characterized by many confounding factors, which might conceal the beneficial effect of the treatment of valve dysfunction in the mid-long-term follow-up. The present review underscores the potential limits of surgical treatment and hypothesized that percutaneous treatment of functional mitral regurgitation, by means of MitraClip, Abbott, Menlo Park, California, might represent a better tool to investigate treatment of functional mitral regurgitation.

Original languageEnglish
JournalJournal of Cardiovascular Medicine
DOIs
Publication statusPublished - Aug 17 2016

Fingerprint

Mitral Valve Insufficiency
Ventricular Dysfunction
Ventricular Remodeling
Ventricular Function
Mitral Valve
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Benfari, G., Dandale, R., Rossi, A., Onorati, F., Mugnai, G., Ribichini, F., ... Vassanelli, C. (2016). Functional mitral regurgitation: are we treating the real target? Journal of Cardiovascular Medicine. https://doi.org/10.2459/JCM.0000000000000429

Functional mitral regurgitation : are we treating the real target? / Benfari, Giovanni; Dandale, Rajesh; Rossi, Andrea; Onorati, Francesco; Mugnai, Giacomo; Ribichini, Flavio; Temporelli, Pier L.; Vassanelli, Corrado.

In: Journal of Cardiovascular Medicine, 17.08.2016.

Research output: Contribution to journalArticle

Benfari, Giovanni ; Dandale, Rajesh ; Rossi, Andrea ; Onorati, Francesco ; Mugnai, Giacomo ; Ribichini, Flavio ; Temporelli, Pier L. ; Vassanelli, Corrado. / Functional mitral regurgitation : are we treating the real target?. In: Journal of Cardiovascular Medicine. 2016.
@article{cfc8eaa435374684919988e7a3cd2296,
title = "Functional mitral regurgitation: are we treating the real target?",
abstract = "Functional mitral regurgitation is a form of valve insufficiency in the presence of anatomically normal mitral valve. The cause of functional mitral regurgitation is left ventricular remodelling that tethers valve leaflet more apically decreasing their coaptation ability. Given the pathophysiologic relation between functional mitral regurgitation and ventricular dysfunction, the valve insufficiency has long been considered a surrogate of ventricular disease. Accordingly, all potential therapeutic strategies able to decrease functional mitral regurgitation have been associated with improved ventricular function. On the contrary, the surgical treatment of functional mitral regurgitation has led to contrasting results, but the main drawback is that it does not improve survival compared with medical therapy. However, surgery is characterized by many confounding factors, which might conceal the beneficial effect of the treatment of valve dysfunction in the mid-long-term follow-up. The present review underscores the potential limits of surgical treatment and hypothesized that percutaneous treatment of functional mitral regurgitation, by means of MitraClip, Abbott, Menlo Park, California, might represent a better tool to investigate treatment of functional mitral regurgitation.",
author = "Giovanni Benfari and Rajesh Dandale and Andrea Rossi and Francesco Onorati and Giacomo Mugnai and Flavio Ribichini and Temporelli, {Pier L.} and Corrado Vassanelli",
year = "2016",
month = "8",
day = "17",
doi = "10.2459/JCM.0000000000000429",
language = "English",
journal = "Journal of Cardiovascular Medicine",
issn = "1558-2027",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Functional mitral regurgitation

T2 - are we treating the real target?

AU - Benfari, Giovanni

AU - Dandale, Rajesh

AU - Rossi, Andrea

AU - Onorati, Francesco

AU - Mugnai, Giacomo

AU - Ribichini, Flavio

AU - Temporelli, Pier L.

AU - Vassanelli, Corrado

PY - 2016/8/17

Y1 - 2016/8/17

N2 - Functional mitral regurgitation is a form of valve insufficiency in the presence of anatomically normal mitral valve. The cause of functional mitral regurgitation is left ventricular remodelling that tethers valve leaflet more apically decreasing their coaptation ability. Given the pathophysiologic relation between functional mitral regurgitation and ventricular dysfunction, the valve insufficiency has long been considered a surrogate of ventricular disease. Accordingly, all potential therapeutic strategies able to decrease functional mitral regurgitation have been associated with improved ventricular function. On the contrary, the surgical treatment of functional mitral regurgitation has led to contrasting results, but the main drawback is that it does not improve survival compared with medical therapy. However, surgery is characterized by many confounding factors, which might conceal the beneficial effect of the treatment of valve dysfunction in the mid-long-term follow-up. The present review underscores the potential limits of surgical treatment and hypothesized that percutaneous treatment of functional mitral regurgitation, by means of MitraClip, Abbott, Menlo Park, California, might represent a better tool to investigate treatment of functional mitral regurgitation.

AB - Functional mitral regurgitation is a form of valve insufficiency in the presence of anatomically normal mitral valve. The cause of functional mitral regurgitation is left ventricular remodelling that tethers valve leaflet more apically decreasing their coaptation ability. Given the pathophysiologic relation between functional mitral regurgitation and ventricular dysfunction, the valve insufficiency has long been considered a surrogate of ventricular disease. Accordingly, all potential therapeutic strategies able to decrease functional mitral regurgitation have been associated with improved ventricular function. On the contrary, the surgical treatment of functional mitral regurgitation has led to contrasting results, but the main drawback is that it does not improve survival compared with medical therapy. However, surgery is characterized by many confounding factors, which might conceal the beneficial effect of the treatment of valve dysfunction in the mid-long-term follow-up. The present review underscores the potential limits of surgical treatment and hypothesized that percutaneous treatment of functional mitral regurgitation, by means of MitraClip, Abbott, Menlo Park, California, might represent a better tool to investigate treatment of functional mitral regurgitation.

UR - http://www.scopus.com/inward/record.url?scp=84983036049&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84983036049&partnerID=8YFLogxK

U2 - 10.2459/JCM.0000000000000429

DO - 10.2459/JCM.0000000000000429

M3 - Article

JO - Journal of Cardiovascular Medicine

JF - Journal of Cardiovascular Medicine

SN - 1558-2027

ER -