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European Heart Journal Advance Access originally published online on October 16, 2006
European Heart Journal 2006 27(22):2615-2616; doi:10.1093/eurheartj/ehl320
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Functional mitral regurgitation in acute coronary syndrome: what determines its prognostic impact?

Luc A. Piérard

Division of Cardiology, University Hospital Sart Tilman, Liège, Belgium

Corresponding author. Tel: +32 4 366 71 94; fax: +32 4 366 71 95. E-mail address: lpierard@chu.ulg.ac.be

This editorial refers to ‘Prognostic significance of functional mitral regurgitation after a first non-ST-segment elevation acute coronary syndrome’{dagger} by L.P. de Isla et al., on page 2655

The first 10% of the full text of this article appears below.

Functional mitral regurgitation (MR) is frequently present in patients with acute coronary syndrome and can be observed by contrast ventriculography or Doppler echocardiography.1–5 It is, however, poorly detected by auscultation.1,6 Ischaemic MR results from either tethering force that restricts the ability of the mitral leaflets to close, reduced left ventricular (LV)-generated closing force, or both.7 Tethering is produced by global LV remodelling—increased LV sphericity and annular dilation—or more frequently by mitral valve distortion, characterized by systolic valvular tenting due to apical and outward displacement of the posterior papillary muscle or of both papillary muscles. Reduced closing force can be determined by reduced LV contractility or LV regional dyssynchrony. In the acute phase of myocardial infarction (MI), MR may pre-exist or result from the acute . . . [Full Text of this Article]

Which factors determine the prognostic impact of functional MR?

Does the myocardial state resulting from the acute coronary syndrome play a role?

The role of dynamic functional MR


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Related articles in EHJ:

Prognostic significance of functional mitral regurgitation after a first non-ST-segment elevation acute coronary syndrome
Leopoldo Perez de Isla, Jose Zamorano, Maribel Quezada, Carlos Almería, José Luis Rodrigo, Viviana Serra, Juan Carlos García Rubira, Antonio Fernandez Ortiz, and Carlos Macaya
EHJ 2006 27: 2655-2660. [Abstract] [FREE Full Text]