Division of Cardiac Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Cardiol Rev. 2010 Nov-Dec;18(6):285-91. doi: 10.1097/CRD.0b013e3181e8e648.
Functional mitral regurgitation (MR) is a common clinical entity which will likely increase in the future due to predicted demographic changes. It is also associated with poor long-term survival. The anatomic structure of the mitral valve apparatus is complex and consists of several components, each of which can be affected by a variety of diseases resulting in MR. In primary MR, the valvular incompetence is caused by compromised or structurally disrupted components of the valve apparatus; the valve in functional MR is structurally normal, with the regurgitation resulting from failure of coaptation of the mitral valve leaflets without coexisting structural changes of the valve itself. Therefore, we defined functional MR as a systolic retrograde flow from the left ventricle into the left atrium due to reduction and/or elimination of the normal systolic coaptation of the mitral valve leaflets. A slow progression of the symptoms is typical for this valve disease and often ends in irreversible left ventricular dysfunction. The pathophysiology and treatment of functional MR are quite complex. This article reviews and summarizes the existing literature, with a focus on the pathophysiology and current treatment of functional MR.
功能性二尖瓣反流（MR）是一种常见的临床病症，由于预测的人口结构变化，未来可能会增加。它也与长期预后不良有关。二尖瓣装置的解剖结构复杂，由几个组成部分组成，每个组成部分都可能受到多种疾病的影响，导致 MR。在原发性 MR 中，瓣膜功能不全是由瓣叶装置受损或结构破坏的部分引起的；功能性 MR 中的瓣膜结构正常，反流是由于二尖瓣瓣叶的正常收缩对合失败引起的，而瓣膜本身没有共存的结构改变。因此，我们将功能性 MR 定义为由于二尖瓣瓣叶的正常收缩对合减少和/或消除而导致的左心室收缩期逆行血流进入左心房。这种瓣膜疾病的症状通常呈缓慢进展，最终往往导致不可逆的左心室功能障碍。功能性 MR 的病理生理学和治疗相当复杂。本文回顾和总结了现有文献，重点介绍了功能性 MR 的病理生理学和当前治疗方法。
