Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2020; 17 (2): 85-153 ➤ Обратимость ишемической митральной регургитации: условия и механизмы обратного ремоделирования, принципы диагностики

Reversibility of ischemic mitral regurgitation: conditions and mechanisms of reverse remodeling, diagnostic principles

Authors: Koksheneva I.V., Maloroeva A.I.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2020-17-2-85-98

UDC: 616.126.42-005.4-008.17-089

Link: Clinical Physiology of Blood Circulaiton. 2020; 17 (2): 85-98

Quote as: Koksheneva I.V., Maloroeva A.I. Reversibility of ischemic mitral regurgitation: conditions and mechanisms of reverse remodeling, diagnostic principles. Clinical Physiology of Circulation. 2020; 17 (2): 85–98 (in Russ.). DOI: 10.24022/1814-6910-2020-17-2-85-98

Keywords:  reversible and irreversible ischemic myocardial dysfunction ischemic remodeling of the left ventricle remodeling of the mitral valve apparatus myocardial revascularization mechanisms of reverse heart remodeling reversibility and irreversibility of ischemic mitral regurgitation

Received / Accepted:  14.01.2020/23.01.2020

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Abstract

Ischemic mitral regurgitation (MR) is a common complication of ischemic heart disease. In the cardiac surgical community debates continue regarding optimal tactics in patients with ischemic MR. This article presents a review of the literature on the mechanisms of reversibility of ischemic MR after myocardial revascularization. In this review, the emphasis is shifted from assessing only the mitral valve to assessing the structural and functional state of the left ventricular myocardium (LV) and its viability as the main determinant of leveling ischemic MR after myocardial revascularization. The “valvulocentric approach” overlooks the main reason for the formation and further dynamics of ischemic MR. While understanding the mechanism of formation of ischemic MR is the key to its effective treatment. Patients with ischemic MR represent a very heterogeneous group, which varies in degree of viability and contractile myocardial reserves, in severity of structural remodeling of the left ventricle and mitral valve apparatus. Whether it is necessary to perform an intervention on the mitral valve or to confine myself to performing myocardial revascularization, can to a large extent help, along with assessing the geometry of the left ventricle and mitral valve apparatus, the study of myocardial viability.

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About Authors

  • Inna V. Koksheneva, Dr. Med. Sc., Senior Researcher; orcid.org/0000-0002-8797-9340
  • Amina I. Maloroeva, Postgraduate


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