RT Book, Section
A1 Bax, Jeroen J.
A1 Marsan, Nina Ajmone
A1 Bijl, Pieter van der
A1 Treede, Hendrik
A1 DeBonis, Michele
A1 Prendergast, Bernard
A1 Iung, Bernard
A1 Delgado,  Victoria
A2 Fuster, Valentin
A2 Narula, Jagat
A2 Vaishnava, Prashant
A2 Leon, Martin B.
A2 Callans, David J.
A2 Rumsfeld, John
A2 Poppas, Athena
SR Print(0)
ID 1191373652
T1 Mitral Regurgitation
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1191373652
RD 2022/07/04
AB Chapter  SummaryThis  chapter  provides  a  comprehensive  overview  of  the  epidemiology,  pathophysiology,  diagnosis,  and  treatment  of  primary  and  secondary  mitral  regurgitation  (MR).  MR  is  the  most  frequent  valve  disease  in  the  population  (estimated  prevalence  20%)  and,  as  a  disease  of  the  elderly,  prevalence  will  increase  steeply  over  the  next  few  decades.  Primary  MR  results  from  valvular  abnormalities  whereas  secondary  MR  is  a  consequence  of  left  ventricular  dysfunction/dilatation  or  left  atrial  enlargement/dysfunction  (see  Fuster  and  Hurst's  Central  Illustration).  Significant  MR  is  associated  with  high  morbidity/mortality  when  left  untreated,  with  5-year  survival  of  46  ±  3%  in  secondary  MR  and  66  ±  3%  in  primary  MR.  Still,  most  MR  patients  are  treated  conservatively.  MR  diagnosis/quantification  is  performed  with  two-  and  three-dimensional  transthoracic  echocardiography,  which  provides  anatomical  and  functional  information  to  understand  the  MR  pathophysiology.  Cardiac  magnetic  resonance  is  ideal  for  MR  quantification.  When  transcatheter  mitral  valve  repair/replacement  is  being  considered,  detailed  anatomical  imaging  of  the  mitral  valve  (including  annular  calcification)  can  be  provided  by  cardiac  computed  tomography.  Surgical  therapies  and  transcatheter  mitral  valve  repair/replacement  are  discussed,  and  a  summary  of  the  recommendations  from  the  latest  ESC/EACTS  and  ACC/AHA  guidelines  for  treatment  of  primary  and  secondary  MR  is  provided.