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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23767

Title: Exercise Dynamics in Secondary Mitral Regurgitation Pathophysiology and Therapeutic Implications
Authors: Bertrand, Philippe
Schwammenthal, Ehud
Levine, Robert A.
Vandervoort, Pieter
Issue Date: 2017
Citation: CIRCULATION, 135(3), p. 297-314
Abstract: Secondary mitral valve regurgitation (MR) remains a challenging problem in the diagnostic workup and treatment of patients with heart failure. Although secondary MR is characteristically dynamic in nature and sensitive to changes in ventricular geometry and loading, current therapy is mainly focused on resting conditions. An exercise-induced increase in secondary MR, however, is associated with impaired exercise capacity and increased mortality. In an era where a multitude of percutaneous solutions are emerging for the treatment of patients with heart failure, it becomes important to address the dynamic component of secondary MR during exercise as well. A critical reappraisal of the underlying disease mechanisms, in particular the dynamic component during exercise, is of timely importance. This review summarizes the pathophysiological mechanisms involved in the dynamic deterioration of secondary MR during exercise, its functional and prognostic impact, and the way current treatment options affect the dynamic lesion and exercise hemodynamics in general.
Notes: [Bertrand, Philippe B.; Vandervoort, Pieter M.] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Bertrand, Philippe B.; Vandervoort, Pieter M.] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium. [Schwammenthal, Ehud] Sheba Med Ctr, Ctr Heart, Tel Hashomer, Israel. [Levine, Robert A.] Harvard Med Sch, Massachusetts Gen Hosp, Cardiac Ultrasound Lab, Boston, MA USA.
URI: http://hdl.handle.net/1942/23767
DOI: 10.1161/CIRCULATIONAHA.116.025260
ISI #: 000392291000013
ISSN: 0009-7322
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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