Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation

Marco Spartera, Maurizio Galderisi, Donato Mele, Matteo Cameli, Antonello D'Andrea, Andrea Rossi, Sergio Mondillo, Giuseppina Novo, Roberta Esposito, Flavio D'Ascenzi, Roberta Montisci, Sabina Gallina, Alberto Margonato, Eustachio Agricola

Research output: Contribution to journalReview articlepeer-review

Abstract

Functional mitral regurgitation (FMR) is a common complication of left ventricle (LV) dysfunction and remodelling. Recently, it has been recognized as an independent prognostic factor in both ischaemic and non-ischaemic LV dysfunctions. In this review article, we discuss the mechanisms through which cardiac dyssynchrony is involved in FMR pathophysiologic cascade and how cardiac resynchronization therapy (CRT) can have therapeutic effects on FMR by reverting specific dyssynchrony pathways.We analyse recent clinical trials focusing on CRT impact on FMR in 'real-world' patients, the limits and future perspectives that could eventually generate new predictors of CRT response in terms of FMR reduction. Finally, we propose a practical diagnostic and therapeutic strategy for the management of symptomatic patients with severe LV dysfunction and concomitant 'prognostic' FMR.

Original languageEnglish
Pages (from-to)471-480
Number of pages10
JournalEuropean Heart Journal Cardiovascular Imaging
Volume17
Issue number5
DOIs
Publication statusPublished - 2016

Keywords

  • Cardiac resynchronization
  • Mitral regurgitation
  • Ventricular dyssynchrony

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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