Section of Cardiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, USA.
Curr Opin Cardiol. 2020 Sep;35(5):454-463. doi: 10.1097/HCO.0000000000000769.
Degenerative mitral regurgitation (DMR) continues to be an important cause of morbidity and mortality with surgical mitral valve repair remaining the gold standard for the treatment of severe disease. The purpose of this review is to summarize recent advances in the understanding of DMR as well as the progress made in its assessment with a focus on imaging techniques.
Recent insights into the anatomy and physiology of DMR challenge the assumption that fibroelastic deficiency and Barlow disease are part of a single DMR spectrum. Advances in echocardiography and cardiovascular MRI have the potential to improve quantification of mitral regurgitation, provide unique information on prognosis and impact of DMR, further the association between DMR and arrhythmic risk and aide in decision-making for DMR treatment.
With growing interest in the use of noninvasive transcatheter therapies in the mitral valve space, comprehensive assessment of the mitral valve is critical to instruct decision-making and guide therapeutic strategy.
退行性二尖瓣关闭不全(DMR)仍然是发病率和死亡率的重要原因,而手术二尖瓣修复仍然是治疗严重疾病的金标准。本文的目的是总结 DMR 理解方面的最新进展,以及评估方法方面的进展,重点是影像学技术。
对 DMR 的解剖和生理学的最新认识挑战了这样一种假设,即纤维弹性缺失和巴洛病是 DMR 单一谱的一部分。超声心动图和心血管磁共振成像的进步有可能改善二尖瓣关闭不全的定量,提供关于预后和 DMR 影响的独特信息,进一步确定 DMR 与心律失常风险之间的关联,并辅助 DMR 治疗的决策。
随着人们对二尖瓣空间中非侵入性经导管治疗的应用越来越感兴趣,对二尖瓣进行全面评估对于指导决策和指导治疗策略至关重要。