Functional mitral regurgitation in patients with heart failure and depressed ejection fraction

Curr Opin Cardiol. 2016 Sep;31(5):483-92. doi: 10.1097/HCO.0000000000000325.

Abstract

Purpose of review: Functional mitral regurgitation (FMR) is a common complication of left ventricular dysfunction. It is now recognized as an important clinical entity and an independent predictor of poor prognosis in cardiomyopathy patients. In this review, we provide a comprehensive summary of the pathophysiology, latest imaging modalities, and diagnostic criteria for FMR. Additionally, we discuss the recent literature on the continuously evolving surgical and percutaneous treatment options.

Recent findings: The criteria for quantification of FMR on echocardiography were updated and are distinct from organic mitral regurgitation in the most recent American College of Cardiology/American Heart Association 2014 valve guidelines. Furthermore, the evolving role of MitraClip for potential treatment of FMR offers exciting prospects to treat high-risk symptomatic patients.

Summary: Our review serves to consolidate the current diagnostic and treatment modalities for FMR and provide a contemporary resource for clinicians while treating patients. Additionally, we identify the gaps present in our knowledge of FMR to guide further clinical investigation.

Publication types

  • Review

MeSH terms

  • Echocardiography
  • Heart Failure / complications*
  • Humans
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / physiopathology*
  • Mitral Valve Insufficiency / surgery
  • Stroke Volume*
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Dysfunction, Left / surgery