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European Heart Journal Advance Access originally published online on January 23, 2006
European Heart Journal 2006 27(6):638-640; doi:10.1093/eurheartj/ehi741
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Left ventricular dyssynchrony and dynamic functional mitral regurgitation: relationship or association?

Luc A. Piérard* and Patrizio Lancellotti

Department of Cardiology, University Hospital Sart Tilman, B-4000 Liege, Belgium

* Corresponding author. Department of Cardiology, University Hospital of Liege, B-4000 Liege, Belgium. Tel: +32 4 366 71 94; fax: +32 4 366 71 95. E-mail address: lpierard@chu.ulg.ac.be

This editorial refers to ‘Myocardial asynchronism is a determinant of changes in functional mitral regurgitation severity during dynamic exercise in patients with chronic heart failure due to severe left ventricular systolic dysfunction’{dagger} by P.V. Ennezat et al., on page 679

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Numerous parameters are associated with a dismal prognosis in heart failure patients. Some of these factors may be mechanistically related, such as increased left ventricular (LV) volume, functional mitral regurgitation (MR), QRS widening, and LV dyssynchrony. Indeed, LV dilation produces distortion of ventricular geometry. The apical and outward displacement of the mitral leaflets restricts their ability to close through tethering forces. QRS widening is frequently associated with LV dyssynchrony. Both dysfunction and dyssynchrony, notably the dyscoordination of the segments containing papillary muscles1 reduce LV-generated mitral valve closing force.

Functional MR varies dynamically depending on annular size, loading conditions, and a balance of closing force and mitral valvular deformation. Dynamic MR can be reliably quantitated during exercise testing. Large exercise-induced increases in ischaemic MR are associated with acute pulmonary oedema2 and a high risk of morbidity and mortality.3 In patients with normal QRS duration . . . [Full Text of this Article]


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Related articles in EHJ:

Myocardial asynchronism is a determinant of changes in functional mitral regurgitation severity during dynamic exercise in patients with chronic heart failure due to severe left ventricular systolic dysfunction
Pierre V. Ennezat, Sylvestre Maréchaux, Thierry Le Tourneau, Nicolas Lamblin, Christophe Bauters, Eric Van Belle, Benjamin Gal, Salem Kacet, Philippe Asseman, Ghislaine Deklunder, Thierry H. LeJemtel, and Pascal de Groote
EHJ 2006 27: 679-683. [Abstract] [Full Text]  



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