Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, University Hospital Sart Tilman, University of Liège, Place du 20 Août 7, 4000 Liège, Belgium.
Cardiac Surgery Unit, GVM Care and Research, Maria Eleonora Hospital, Viale della Regione Siciliana Nord Ovest 1571, Palermo, Italy.
Nat Rev Cardiol. 2015 Apr;12(4):212-9. doi: 10.1038/nrcardio.2015.16. Epub 2015 Feb 10.
Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in MR and systolic pulmonary artery pressure during exercise. Identifying patients who have dynamic MR, and understanding the mechanisms underlying the condition, can potentially influence revascularization strategies (such as the surgical restoration of coronary blood flow) and interventional treatment (including cardiac resynchronization therapy and new approaches targeted to the mitral valve).
二尖瓣反流（MR）是一种常见的、进行性的、难以治疗的疾病。MR 具有动态性，会随着各种刺激（如运动和缺血）而发生生理波动，这可能会引发症状的发展和随后的心脏事件。在慢性原发性和继发性 MR 中，运动超声心动图可可靠地检查 MR 的动态行为。MR 的动态波动也具有预后价值；在运动过程中反流容积明显增加或出现收缩期肺动脉压升高的患者，其无症状生存时间低于在运动过程中 MR 和收缩期肺动脉压无明显变化的患者。识别出具有动态性 MR 的患者，并了解其发病机制，可能会影响血运重建策略（如冠状动脉血流的手术恢复）和介入治疗（包括心脏再同步治疗和针对二尖瓣的新方法）。
