Improved Papillary Muscle Function Attenuates Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy After Cardiac Resynchronization Therapy

Karvounis, Haralambos; Dalamaga, E.; Papadopoulos, Christodoulos; Karamitsos, Theodoros D.; Vassilikos, Vassilios; Paraskevaidis, Stelios; Styliadis, Ioannis H.; Parharidis, Georgios E.; Louridas, Georgios E.

doi:10.1016/j.echo.2006.04.022

Cited by 31 publications

(20 citation statements)

References 28 publications

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“…Successful cardiac resynchronization therapy results in improvement in distance walked in 6 minutes and peak V O, 113,114 likely because of improved autonomic nervous system modulation. 114 Other factors that may positively affect aerobic capacity as a result of cardiac resynchronization therapy include decreased mitral regurgitation 115 and increased left ventricular efficiency. 116 …”

Section: Pacemakersmentioning

confidence: 99%

Assessment of Functional Capacity in Clinical and Research Settings

Arena¹,

Myers²,

Williams³

et al. 2007

Circulation

478

219

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Section: Pacemakersmentioning

confidence: 99%

Assessment of Functional Capacity in Clinical and Research Settings

Arena¹,

Myers²,

Williams³

et al. 2007

Circulation

478

219

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“…In addition, CRT lessens functional MR by correcting papillary muscle dyssynchrony as assessed by mechanical activation strain maps or 2-dimensional strain imaging. 21,22 In addition to the increase in transmitral pressure force and the interpapillary muscle resynchronization, Karvounis et al 23 reported that CRT improves systolic strain of papillary muscles and adjacent LV walls. Last, CRT may improve LV longitudinal function and reduce subvalvular traction, as evidenced by decreased apical displacement of the coaptation point.…”

Section: Discussionmentioning

confidence: 99%

Functional Mitral Regurgitation at Rest Determines the Acute Hemodynamic Response to Cardiac Resynchronization Therapy During Exercise: An Acute Exercise Echocardiographic Study

Maréchaux

Pinçon

Gal

et al. 2009

Journal of the American Society of Echocardiography

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“…CRT reduces the amount of FMR in patients with LV systolic failure (9)(10)(11)(12)(13)(14)(33)(34)(35)(36)(37)(38). Effects of CRT on FMR are acute and longterm, due to the reverse remodeling of the LV.…”

Section: Cardiac Resynchronization Therapy and Functional Mitral Regumentioning

confidence: 99%

“…CRT reduces the amount of FMR in patients with left ventricular (LV) systolic failure (9)(10)(11)(12)(13)(14). Studies have shown that the severity of FMR was correlated with the papillary muscle dyssynchrony (PMD) (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Functional mitral regurgitation and papillary muscle dyssynchrony in patients with left ventricular systolic dysfunction

Güler¹,

Dündar²,

Tigen³

2011

Anadolu Kardiyol Derg

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ÖZETSistolik fonksiyonları bozuk olan genişlemiş bir kalpte, mitral kapakta yapısal bir bozukluk olmasa bile fonksiyonel olarak yetersizlik meydana gelebilir. Fonksiyonel mitral yetersizliğinin gelişmesinde birçok mekanizma beraber rol alır. Bunlar, mitral kapağı kalbin apeksine doğru çeken kuvvetlerdeki artış, sistol sırasında kapağı kapayıcı kuvvetlerdeki azalma ve mekanik ve elektriksel dissenkronidir. Papiller adele dissenkronisi de fonksiyonel mitral yetersizliğine katkıda bulunan nedenlerden biridir. Sistolik kalp yetersizliği olan hastalarda -bazı durumlarda yanıt alına-mayabilirse de-kardiyak resenkronizasyon tedavisi ile fonksiyonel mitral yetersizliğinin gerilediği bilinir. Papiller adele dissenkronisi fonksiyonel mitral yetersizliğinin gerilemesi bakımından kardiyak resenkronizasyon tedavisine yanıtı tahmin edebilir ve koroner revaskülarizasyon, mitral onarım veya kardiyak resenkronizasyon tedavisi gibi farklı tedavilerden hangisinin seçileceği ya da beraber uygulanacağı konusunda yol göste-rici olabilir. Bu derlemede fonksiyonel mitral yetersizliğinin mekanizmaları, papiller adele dissenkronisi ve fonksiyonel mitral yetersizliği arasın-daki ilişki, papiller adele dissenkronisi ile kardiyak resenkronizasyon tedavisi sonrası fonksiyonel mitral yetersizliğindeki gerileme arasındaki ilişki incelenmiştir. ABSTRACTIn a dilated heart with impaired systolic functions, functional mitral regurgitation could be seen even in the presence of structurally normal mitral apparatus. A number of mechanisms play role in the development of functional mitral regurgitation. These are increased mitral tethering forces, reduction in closing forces and mechanical and electrical dyssynchrony. Papillary muscle dyssynchrony has also been shown to be related with functional mitral regurgitation. Cardiac resynchronization therapy is known to reduce the amount of functional mitral regurgitation in patients with left ventricular systolic failure although some may not respond to treatment with cardiac resynchronization therapy. Papillary muscle dyssynchrony may predict the response of cardiac resynchronization therapy on the regression of functional mitral regurgitation and may suggest the suitable therapeutic options, such as cardiac resynchronization therapy, mitral valve repair, coronary revascularization separately or in combination. In this review, the mechanisms of functional mitral regurgitation, papillary muscle dyssynchrony and its relationship with functional mitral regurgitation and the relationship of papillary muscle dyssynchrony with the improvement of functional mitral regurgitation after cardiac resynchronization therapy are focused. (Anadolu Kardiyol Derg 2011; 11: 450-5)

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Improved Papillary Muscle Function Attenuates Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy After Cardiac Resynchronization Therapy

Cited by 31 publications

References 28 publications

Assessment of Functional Capacity in Clinical and Research Settings

Assessment of Functional Capacity in Clinical and Research Settings

Functional Mitral Regurgitation at Rest Determines the Acute Hemodynamic Response to Cardiac Resynchronization Therapy During Exercise: An Acute Exercise Echocardiographic Study

Functional mitral regurgitation and papillary muscle dyssynchrony in patients with left ventricular systolic dysfunction

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