Importance of Myocardial Fibrosis in Functional Mitral Regurgitation
Functional MR, also known as secondary MR, occurs as a consequence of underlying LV dysfunction or remodeling. The regurgitation of blood back into the left atrium due to an incompetent mitral valve can lead to increased LV volumes and pressures, further exacerbating the underlying myocardial pathology. MF, characterized by the excessive deposition of collagen and extracellular matrix proteins in the myocardium, is a key player in this process.
The calculated RegFrac of 36% and 13% of MF (percent of LV mass) indicates a patient with greater hemodynamic burden of regurgitation. This suggests that the extent of MF in the LV can directly impact the severity of MR and the associated hemodynamic consequences. Therefore, evaluating and quantifying MF LV in patients with functional MR is crucial for understanding the underlying pathophysiology and guiding treatment decisions.
The association of Left Ventricular Histologically Verified Myocardial Fibrosis
Histological examination of LV tissue samples can provide valuable insights into the presence and distribution of MF in patients with functional MR. Studies have shown a strong association between histologically verified MF and the severity of MR, as well as adverse LV remodeling. The fibrotic changes in the myocardium can contribute to LV stiffness, impaired contractility, and further progression of MR.
Focus Issue on Secondary (Functional) Mitral Regurgitation
A focus on secondary MR highlights the importance of considering the underlying myocardial substrate in the management of patients with this condition. While the primary treatment goal is often directed towards addressing the mitral valve pathology, understanding the role of MF LV in the development and progression of MR is essential for optimizing patient outcomes. Targeted therapies that aim to reduce MF and improve LV function may have a significant impact on mitigating MR and improving overall cardiac function.
Histologically Validated Myocardial Fibrosis in Relation to Left Ventricular Function
The presence of histologically validated MF in the LV can have profound implications for left ventricular function. Fibrotic changes in the myocardium can disrupt normal cardiac architecture, impair electrical conduction, and promote arrhythmias. Additionally, the stiffening of the LV due to fibrosis can compromise diastolic function and lead to increased filling pressures, further contributing to the hemodynamic burden of MR.
Prognostic Significance of Myocardial Fibrosis Quantification by MF LV
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