TY - JOUR
T1 - Atrial Functional Mitral Regurgitation
T2 - A JACC: Cardiovascular Imaging Expert Panel Viewpoint
AU - Zoghbi, William A.
AU - Levine, Robert A.
AU - Flachskampf, Frank
AU - Grayburn, Paul
AU - Gillam, Linda
AU - Leipsic, Jonathon
AU - Thomas, James D.
AU - Kwong, Raymond Y.
AU - Vandervoort, Pieter
AU - Chandrashekhar, Y.
N1 - Publisher Copyright:
© 2022 American College of Cardiology Foundation
PY - 2022/11
Y1 - 2022/11
N2 - Functional or secondary mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality. Mechanistically, secondary MR is attributable to an imbalance between mitral leaflet tethering and closure forces, leading to poor coaptation. The pathophysiology of functional MR is most often the result of abnormalities in left ventricular function and remodeling, seen in ischemic or nonischemic conditions. Less commonly and more recently recognized is the scenario in which left ventricular geometry and function are preserved, the culprit being mitral annular enlargement associated with left atrial dilatation, termed atrial functional mitral regurgitation (AFMR). This most commonly occurs in the setting of chronic atrial fibrillation or heart failure with preserved ejection fraction. There is variability in the published reports and in current investigations as to the definition of AFMR. This paper reviews the pathophysiology of AFMR and focus on the need for a collective definition of AFMR to facilitate consistency in reported data and enhance much-needed research into outcomes and treatment strategies in AFMR.
AB - Functional or secondary mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality. Mechanistically, secondary MR is attributable to an imbalance between mitral leaflet tethering and closure forces, leading to poor coaptation. The pathophysiology of functional MR is most often the result of abnormalities in left ventricular function and remodeling, seen in ischemic or nonischemic conditions. Less commonly and more recently recognized is the scenario in which left ventricular geometry and function are preserved, the culprit being mitral annular enlargement associated with left atrial dilatation, termed atrial functional mitral regurgitation (AFMR). This most commonly occurs in the setting of chronic atrial fibrillation or heart failure with preserved ejection fraction. There is variability in the published reports and in current investigations as to the definition of AFMR. This paper reviews the pathophysiology of AFMR and focus on the need for a collective definition of AFMR to facilitate consistency in reported data and enhance much-needed research into outcomes and treatment strategies in AFMR.
KW - atrial fibrillation
KW - atrial functional mitral regurgitation
KW - functional mitral regurgitation
KW - heart failure with preserved ejection fraction
KW - ventricular functional mitral regurgitation
UR - http://www.scopus.com/inward/record.url?scp=85140576243&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85140576243&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2022.08.016
DO - 10.1016/j.jcmg.2022.08.016
M3 - Editorial
C2 - 36357130
AN - SCOPUS:85140576243
SN - 1936-878X
VL - 15
SP - 1870
EP - 1882
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 11
ER -