Preoperative Left Ventricular Function in Degenerative Mitral Valve Disease

Mitral valve prolapse and left ventricular systolic function

“…At present, despite the introduction of three-dimensional trans-oesophageal echocardiography in routine practice, transthoracic echocardiography is the optimal non-invasive technique to determine the morphology and to identify aetiologies of mitral valve prolapse compared with surgical and pathological findings. 4 Some previous pathology studies in myxomatous mitral valve prolapse provided evidences for intramyocardial extracellular matrix changes as a specific reflection of a general myxomatous alteration in cardiac connective tissue. 5,6 These changes may cause both left ventricular enlargement and systolic dysfunction in classical mitral valve prolapse.…”

“…7 In patients with severe chronic mitral regurgitation, we found significant decrease of the global longitudinal systolic strain in myxomatous Barlow's disease compared with fibroelastic deficiency. 4 Importantly, the subclinical regional and global left ventricular systolic dysfunction in mitral valve prolapse were not revealed by conventional echocardiography and required a novel echocardiographybased or MRI-based strain technique.…”

“…In our study, myxomatous changes in mitral leaflets were identified only by transthoracic echocardiography and have not been confirmed by histological examinations. At present, despite the introduction of three-dimensional trans-oesophageal echocardiography in routine practice, transthoracic echocardiography is the optimal non-invasive technique to determine the morphology and to identify aetiologies of mitral valve prolapse compared with surgical and pathological findings 4 …”

EuroEcho and other imaging modalities: highlights

“…16 Furthermore, concomitant LV and RV impairment seemed to be a powerful predictor of both cardiovascular events and overall survival. Despite preserved LV function, as assessed by LVEF, Malev et al 17 showed that primary MR due to Barlow's disease was significantly associated with reduced preoperative LV longitudinal, circumferential and radial strains, and strain rates, when compared with fibroelastic deficiency. These differences could be explained by intramyocardial extracellular matrix damage frequently encountered in Barlow's disease.…”