Functional mitral regurgitation: Signification

peer reviewedFunctional mitral regurgitation is frequent in heart failure patients. It is characteristically dynamic and sensitive to changes in ventricular size, shape, and loading, which increase leaflet tethering and/or the reduced mitral valve closing force. In heart failure patients, exercise-induced increases in MR severity contribute to a limitation of exercise capacity and convey a poor prognosis. Such dynamic MR changes during exercise are usually accompanied by increases in systolic pulmonary artery pressure and are related to changes in mitral valve configuration and mitral apparatus geometry at both ends of the tethered leaflets and heterogeneous activation sequence of the basal left ventricular walls, namely dynamic left ventricular dyssynchrony