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退行性二尖瓣反流:评估、体格检查和影像学检查。

Degenerative Mitral Regurgitation: Assessment, Physical Examination, and Imaging.

机构信息

Cardiovascular Center Darmstadt, Darmstadt, Germany.

The Heart Institute, Sheba Medical Center, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Curr Cardiol Rep. 2019 Jul 22;21(8):85. doi: 10.1007/s11886-019-1163-3.

Abstract

PURPOSE OF REVIEW

In this review, we provide a comprehensive approach to assess degenerative mitral regurgitation.

RECENT FINDINGS

In the evaluation of MR, it is important to differentiate between primary (degenerative/organic) MR in which an intrinsic mitral valve lesion(s) is responsible for the occurrence of MR and secondary (functional) MR where the mitral valve is structurally normal, but alterations of the left ventricular geometry cause deterioration of the MV apparatus. Advanced imaging modalities, foremost two-dimensional and three-dimensional echocardiography, are essential for this determination. In the evaluation of degenerative MR, the exact mechanism, the extent of the disease, associated valve lesions, the grade of mitral regurgitation severity, and hemodynamic consequences require careful assessment in order to provide patients with appropriate monitoring and treatment.

摘要

目的综述

在本次综述中,我们提供了一种全面的方法来评估退行性二尖瓣反流。

最近的发现

在评估二尖瓣反流时,区分原发性(退行性/器质性)二尖瓣反流和继发性(功能性)二尖瓣反流非常重要。在原发性二尖瓣反流中,固有二尖瓣病变导致二尖瓣反流的发生,而在继发性二尖瓣反流中,二尖瓣结构正常,但左心室几何形状的改变导致二尖瓣装置恶化。二维和三维超声心动图等先进的成像方式对于这一诊断至关重要。在退行性二尖瓣反流的评估中,需要仔细评估确切的机制、疾病的严重程度、相关瓣膜病变、二尖瓣反流严重程度的分级以及血流动力学后果,以便为患者提供适当的监测和治疗。

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