Actualización en insuficiencia mitral funcional: una revisión integral
DOI:
https://doi.org/10.47487/apcyccv.v1i3.70Palabras clave:
insuficiencia de la vávula mitral, insuficiencia cardiaca, disfunción ventricular, ecocardiografíaResumen
Los avances en el manejo de la insuficiencia mitral (IM) funcional en las últimas décadas, hacen que el conocimiento de la misma sea de suma importancia para el cardiólogo clínico, al tener una prevalencia cada vez mayor en pacientes mayores de 50 años. Esta revisión tiene como objetivo dar a conocer de una manera integral las bases fisiopatológicas de la IM para diferenciar sus mecanismos, y correlacionarlos con los hallazgos clínicos, hemodinámicos y de imágenes que valoran la severidad de la enfermedad. Estos datos son relevantes para la adecuada selección del paciente y del momento oportuno de las intervenciones terapéuticas, lo cual involucra a un equipo multidisciplinario en la toma de decisiones para lograr el mayor beneficio dentro de las opciones de tratamiento de esta patología.
Descargas
Referencias
Del Forno B, De Bonis M, Agricola E, et al. Mitral valve regurgitation: a disease with a wide spectrum of therapeutic options [published online ahead of print, 2020 Jun 29]. Nat Rev Cardiol. 2020;10.1038/s41569-020-0395-7. DOI:10.1038/s41569-020-0395-7
Shah T, Zhong M, Minutello RM. Functional Mitral Regurgitation in Heart Failure [published correction appears in Cardiol Rev. 2020 Jan/Feb;28(1):52]. Cardiol Rev. 2019;27(6):327-36. DOI: 10.1097/crd.0000000000000269
Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368(9540):1005–11. DOI: 10.1016/S0140-6736(06)69208-8
De Marchena E, Badiye A, Robalino G, et al. Respective prevalence of the different carpentier classes of mitral regurgitation: a stepping stone for future therapeutic research and development. J Card Surg. 2011;26(4):385-92. doi:10.1111/j.1540-8191.2011.01274.x
Andell P, Li X, Martinsson A, et al. Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study. Heart. 2017;103(21): 1696–703. DOI: 10.1136/heartjnl-2016-310894
Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(25):e1159-e95. DOI:10.1161/CIR.0000000000000503
Comín J, Manito N, Roca J, et al. Insuficiencia mitral funcional. Fisiopatología e impacto del tratamiento médico y de las técnicas quirúrgicas de reducción ventricular izquierda. Rev Española Cardiol. 1999;52(7):512–20. DOI: 10.1016/S0300-8932(99)74959-6
Agricola E, Oppizzi M, Pisani M, et al. Ischemic mitral regurgitation: Mechanisms and echocardiographic classification. Eur J Echocardiogr. 2008;9(2):207–21. DOI: 10.1016/j.euje.2007.03.034
Rodríguez-Roda J, Ruiz M, Rodríguez-Abella H, et al. Situaciones Especiales. Insuficiencia Mitral Isquémica. Cir. Cardiov. 2010;17(4):337-44. DOI: 10.1016/S1134-0096(10)70084-X
Varma PK, Krishna N, Jose RL, et al. Ischemic mitral regurgitation. Ann Card Anaesth. 2017;20(4):432-439. DOI:10.4103/aca.ACA_58_17
Hung JW. Ischemic (functional) mitral regurgitation. Cardiol Clin 2013;31(2):231-236. DOI: 10.1016/j.ccl.2013.04.003
Borger MA, Alam A, Murphy PM, et al. Chronic ischemic mitral regurgitation: repair, replace or rethink? Ann Thorac Surg. 2006;81(3):1153-1161. DOI: 10.1016/j.athoracsur.2005.08.080
Messas E, Guerrero JL, Handschumacher MD, et al. Paradoxic decrease in ischemic mitral regurgitation with papillary muscle dysfunction: Insights from three-dimensional and contrast echocardiography with strain rate measurement. Circulation. 2001;104(16):1952–7. DOI: 10.1161/hc4101.097112
Otsuji Y, Handschumacher MD, Liel-Cohen N, et al. Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction: Three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation. J Am Coll Cardiol. 2001;37(2):641–8. DOI: 10.1016/s0735-1097(00)01134-7
Lancellotti P, Dulgheru R, Marchetta S, et al. Valve Disease in Heart Failure: Secondary but Not Irrelevant. Heart Fail Clin. 2019;15(2):219-27. DOI:10.1016/j.hfc.2018.12.014
He S, Fontaine AA, Schwammenthal E, et al. Integrated mechanism for functional mitral regurgitation: leaflet restriction versus coapting force: in vitro studies. Circulation. 1997;96(6):1826-34. DOI: 10.1161/01.cir.96.6.1826
Watanabe N, Ogasawara Y, Yamaura Y, et al. Quantitation of mitral valve tenting in ischemic mitral regurgitation by transthoracic real-time three-dimensional echocardiography. J Am Coll Cardiol. 2005;45(5):763–9. DOI: 10.1016/j.jacc.2004.11.048
Chaput M, Handschumacher MD, Tournoux F, et al. Mitral leaflet adaptation to ventricular remodeling occurrence and adequacy in patients with functional mitral regurgitation. Circulation. 2008;118(8):845–52. DOI: 10.1161/CIRCULATIONAHA.107.749440.
Dal-Bianco JP, Aikawa E, Bischoff J, et al. Active adaptation of the tethered mitral valve: Insights into a compensatory mechanism for functional mitral regurgitation. Circulation. 2009;120(4):334–42. DOI: 10.1161/CIRCULATIONAHA.108.846782
Inciardi RM, Rossi A, Benfari G, et al. Fill in the Gaps of Secondary Mitral Regurgitation: a Continuum Challenge From Pathophysiology to Prognosis. Curr Heart Fail Rep. 2018;15(2):106–15. DOI: 10.1007/s11897-018-0379-7
Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation: A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2017;30(4):303-71. DOI: http://dx.doi.org/10.1016/j.echo.2017.01.007
Srichai MB, Grimm RA, Stillman AE, et al. Ischemic mitral regurgitation: impact of the left ventricle and mitral valve in patients with left ventricular systolic dysfunction. Ann Thorac Surg. 2005;80(1):170-8. DOI: 10.1016/j.athoracsur.2005.01.068
Otsuji Y, Handschumacher MD, Schwammenthal E, et al. Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation. 1997 Sep 16;96(6):1999-2008. DOI: doi.org/10.1161/01.CIR.96.6.1999
Uretsky S, Gillam L, Lang R, et al. Discordance between echocardiography and MRI in the assessment of mitral regurgitation severity: a prospective multicenter trial. J Am Coll Cardiol. 2015;65(11):1078-88. DOI: 10.1016/j.jacc.2014.12.047
Essayagh B, Iacuzio L, Civaia F, Avierinos JF, Tribouilloy C, Levy F. Usefulness of 3-Tesla Cardiac Magnetic Resonance to Detect Mitral Annular Disjunction in Patients with Mitral Valve Prolapse. Am J Cardiol. 2019;124(11):1725-30. DOI:10.1016/j.amjcard.2019.08.047
Han Y, Peters D, Salton C, et al. Cardiovascular Magnetic Resonance Characterization of Mitral Valve Prolapse. JACC Cardiovasc Imaging. 2008;1(3):294-303. DOI:10.1016/j.jcmg.2008.01.013
Miller MA, Dukkipati SR, Turagam M, Liao SL, Adams DH, Reddy VY. Arrhythmic Mitral Valve Prolapse: JACC Review Topic of the Week. J Am Coll Cardiol. 2018;72(23 Pt A):2904-14. DOI:10.1016/j.jacc.2018.09.048
Bonow RO, O'Gara PT, Adams DH, et al. 2020 Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation: A Report of the American College of Cardiology Solution Set Oversight Committee [published correction appears in J Am Coll Cardiol. 2020 Jun 16;75(23):3000]. J Am Coll Cardiol. 2020;75(17):2236-70. DOI:10.1016/j.jacc.2020.02.005
Nishino S, Watanabe N, Ashikaga K, et al. Reverse Remodeling of the mitral valve complex after radiofrequency catheter ablation for atrial fibrillation: A Serial 3-Dimensional Echocardiographic Study. Circ Cardiovasc Imaging. 2019;12(10): e009317. DOI: 10.1161/circimaging.119.009317
Boltwood CM Jr, Shah PM. Secondary Mitral Regurgitation. J Am Coll Cardiol. 2015;66(17):1946-47. DOI: 10.1016 / j.jacc.2015.07.078
Comin-Colet J, Sánchez-Corral MA, Manito N, et al. Effect of carvedilol therapy on functional mitral regurgitation, ventricular remodeling, and contractility in patients with heart failure due to left ventricular systolic dysfunction. Transplant Proc. 2002;34(1):177-8. DOI: 10.1016/s0041-1345(01)02717-8
Lowes BD, Gill EA, Abraham WT, et al. Effects of carvedilol on left ventricular mass, chamber geometry, and mitral regurgitation in chronic heart failure. Am J Cardiol. 1999;83(8):1201-05. DOI: 10.1016/s0002-9149(99)00059-4
Waagstein F, Stromblad O, Andersson B, et al. Increased exercise ejection fraction and reversed remodeling after long-term treatment with metoprolol in congestive heart failure: a randomized, stratified, double-blind, placebo-controlled trial in mild to moderate heart failure due to ischemic or idiopathic dilated cardiomyopathy. Eur J Heart Fail. 2003;5(5):679–91. DOI: 10.1016/s1388-9842(03)00105-3
Kang D-H, Park S-J, Shin S-H, Hong GR, Lee S, Kim MS, et al. Angiotensin receptor neprilysin inhibitor for functional mitral regurgitation. Circulation. 2019;139(11):1354–65. DOI:10. 1161/CIRCULATIONAHA.118.037077.
Levine AB, Muller C, Levine TB. Effects of high-dose lisinopril-isosorbide dinitrate on severe mitral regurgitation and heart failure remodeling. Am J Cardiol. 1998;82(10):1299–30. DOI: 10.1016/s0002-9149(98)00623-7
St John Sutton MG, Plappert T, Abraham WT, et al. Effect of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure. Circulation. 2003;107(15):1985-90.DOI: 10.1161/01.CIR.0000065226.24159.E9
Cleland J, Freemantle N, Ghio S, et al. Predicting the long-term effects of cardiac resynchronization therapy on mortality rom baseline variables and the early response. A report from the CARE-HF (Cardiac Resynchronization in Heart Failure) Trial. J Am Coll Cardiol. 2008;52(6): 438–45. DOI: 10.1016 / j.jacc.2008.04.036.
Cazeau S, Leclercq C, Lavergne T, Walker S, Varma C, Linde C, et al. for the Multisite Stimulation in Cardiomyopathies (MUSTIC) Study Investigators. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med. 2001;344(12):873–80. DOI: 10.1056/NEJM200103223441202
Sitges M, Vidal B, Delgado V, et al. Long-term effect of cardiac resynchronization therapy on functional mitral valve regurgitation. Am J Cardiol. 2009;104(3):383–8. DOI: 10.1016/j.amjcard.2009.03.060
Cabrera-Bueno F, Molina-Mora MJ, Alzueta J, et al. Persistence of secondary mitral regurgitation and response to cardiac resynchronization therapy. Eur J Echocardiogr. 2010;11(2):131–7. DOI: 10.1093/ejechocard/jep184.
Di Biase L, Auricchio A, Mohanty P, et al. Impact of cardiac resynchronization therapy on the severity of mitral regurgitation. Europace. 2011;13 (6):829–38. DOI: 10.1093/europace/eur047
Regueiro A, Granada JF, Dagenais F, Rodés-Cabau J. Transcatheter Mitral Valve Replacement: Insights From Early Clinical Experience and Future Challenges. J Am Coll Cardiol. 2017;69(17):2175-92. DOI: 10.1016/j.jacc.2017.02.045
Nappi F, Avtaar Singh SS, Padala M, et al. The Choice of Treatment in Ischemic Mitral Regurgitation With Reduced Left Ventricular Function. Ann Thorac Surg. 2019;108(6):1901-12. DOI: 10.1016/j.athoracsur.2019.06.039
Feldman T, Kar S, Elmariah S, et al. Randomized comparison of percutaneous repair, J Am Coll Cardiol. 2015;66(25) :2844-54 DOI: 10.1056/NEJMoa1805374
Obadia JF, Messika-Zeitoun D, Leurent G, et al. Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation. N Engl J Med. 2018 ;379(24) 2297-30. DOI: 10.1056/NEJMoa1805374
Stone GW, Lindenfeld J, Abraham WT, et al. Transcatheter Mitral-Valve Repair in Patients with Heart Failure. N Engl J Med. 2018;379(24):2307-18. DOI: 10.1056/NEJMoa1806640
Chan KM, Punjabi PP, Flather M, et al. Coronary artery bypass surgery with or without mitral valve annuloplasty in moderate functional ischemic mitral regurgitation: final results of the Randomized Ischemic Mitral Evaluation (RIME) trial. Circulation. 2012;126(21): 2502–10. DOI: 10.1161/CIRCULATIONAHA.112.143818
Kon MW, Myerson SG, Moat NE, et al. Quantification of regurgitant fraction in mitral regurgitation by cardiovascular magnetic resonance: comparison of techniques. J Heart Valve Dis. 2004;13(4):600–7. PMID: 15311866
Aphram G, De Kerchove L, Mastrobuoni S, et al. Re- repair of the failed mitral valve: insights into aetiology and surgical management. Eur. J. Cardiothorac Surg. 2018; 54(4): 774–80. DOI: 10.1093/ejcts/ezy111.
