Determinants of exercise-induced changes in mitral regurgitation in patients with coronary artery disease and left ventricular dysfunction

Abstract

The degree of MR at rest is unrelated to exercise-induced changes in EROs, which are related to those in local LV remodeling and in mitral deformation but not those in global LV function.

Secondary Mitral Regurgitation in Heart Failure with Reduced or Preserved Left Ventricular Ejection Fraction

“…Altogether, a decrease in regurgitant flow is associated with an improved forward stroke volume and thereby end-organ perfusion. Besides increased loading conditions, active myocardial ischemia contributes to worsening secondary MR, while medical and nonpharmacological treatments including revascularization and cardiac resynchronization therapy reduce the amount of MR [19,20,21,22,23,24]. A major feature of secondary MR in HFrEF is its dynamic nature with exercise.…”

The evolving role of multimodality imaging in valvular heart disease

“…The correlation between the severity of MR at rest and its augmentation during exercise may be weak, especially in ischaemic MR 6. This observation is particularly pertinent in the assessment of patients whose symptoms on exertion appear excessive for the severity of MR identified on resting echocardiography.…”

Stress echocardiography for selecting potential responders to cardiac resynchronisation therapy

“…Nonetheless, these results must be interpreted cautiously because none of the patients without MR at rest developed MR during exercise and also because LV dyssynchrony was not considered. Functional MR is frequently dynamic during exercise and is related to dynamic distortion of mitral valve geometry and to dynamic LV dyssynchrony 17 26. CRT has also been shown to attenuate exercise-induced increase in MR 27.…”