Assessment of Mitral Valve Reserve Function A Structural Approach to
Ischemic Mitral Regurgitation
Abstract
Ischemic mitral regurgitation (IMR) is one of the common complications
of coronary heart disease. The primary underlying mechanism is
ventricular myopathy rather than disease of the valve itself. The
decrease of myocardial blood supply will lead to myocardial damage,
which will lead to the left ventricular remodeling, left ventricular
enlargement, annular dilation, papillary muscle displacement and limited
leaflet activity, resulting in mitral regurgitation. IMR has a certain
effect on the prognosis of coronary heart disease, and the incidence
rate of IMR has been increasing in recent years. IMR is a complex
dynamic process, and it is a great challenge to deal with IMR. For
patients with moderate or severe IMR, there are still many challenges
and controversies in the choice of surgical methods. This article
reviews the pathological process of left ventricular remodeling, the
evaluation of IMR, the choice of mitral valve (MV) repair or
replacement, and the reserve of MV function. Our review suggests that
assessment of MV reserve function may be a predictor of IMR. In the
future, assessment of MV reserve function may provide further useful
information for evaluating MV function and determining MV repair or
replacement in patients with IMR.