De Zan Giulia, van der Bilt Ivo A C, Broekhuizen Lysette N, Cramer Maarten J, Danad Ibrahim, van Osch Dirk, Patti Giuseppe, van Rosendael Philippe J, Teske Arco J, van der Harst Pim, Guglielmo Marco
Department of Translational Medicine, Division of Cardiology, University of Eastern Piedmont, Maggiore della Carità Hospital, 28100 Novara, Italy.
Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, 3584 CX Utrecht, The Netherlands.
Rev Cardiovasc Med. 2024 Jan 16;25(1):29. doi: 10.31083/j.rcm2501029. eCollection 2024 Jan.
Multivalvular heart disease (MVD) implies the presence of concomitant valvular lesions on two or more heart valves. This condition has become common in the few last years, mostly due to population aging. Every combination of valvular lesions uniquely redefines the hemodynamics of a patient. Over time, this may lead to alterations in left ventricle (LV) dimensions, shape and, eventually, function. Since most of the echocardiographic parameters routinely used in the valvular assessment have been developed in the context of single valve disease and are frequently flow- and load-dependent, their indiscriminate use in the context of MVD can potentially lead to errors in judging lesion severity. Moreover, the combination of non-severe lesions may still cause severe hemodynamic consequences, and thereby systolic dysfunction. This review aims to discuss the most frequent combinations of MVD and their echocardiographic caveats, while addressing the opportunities for a multimodality assessment to achieve a better understanding and treatment of these patients.
多瓣膜心脏病（MVD）意味着两个或更多心脏瓣膜同时存在瓣膜病变。在过去几年中，这种情况变得很常见，主要是由于人口老龄化。瓣膜病变的每种组合都独特地重新定义了患者的血流动力学。随着时间的推移，这可能会导致左心室（LV）尺寸、形状以及最终功能的改变。由于大多数常规用于瓣膜评估的超声心动图参数是在单瓣膜疾病的背景下开发的，并且经常依赖于血流和负荷，因此在MVD的情况下不加区分地使用这些参数可能会导致判断病变严重程度时出现错误。此外，非严重病变的组合仍可能导致严重的血流动力学后果，从而导致收缩功能障碍。本综述旨在讨论MVD最常见的组合及其超声心动图注意事项，同时探讨多模态评估的机会，以更好地理解和治疗这些患者。
