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S. Myerson, J. D'arcy, J. Christiansen, L. Dobson, R. Mohiaddin, J. Francis, B. Prendergast, J. Greenwood, T. Karamitsos, S. Neubauer (2016)
Determination of Clinical Outcome in Mitral Regurgitation With Cardiovascular Magnetic Resonance QuantificationCirculation, 133
V. Nkomo, J. Gardin, T. Skelton, J. Gottdiener, C. Scott, M. Enriquez-Sarano (2006)
Burden of valvular heart diseases: a population-based studyThe Lancet, 368
Christopher Kramer, Jorg Barkhausen, Scott Flamm, Raymond Kim, E. Nagel (2008)
Standardized cardiovascular magnetic resonance imaging (CMR) protocols, society for cardiovascular magnetic resonance: board of trustees task force on standardized protocolsJournal of Cardiovascular Magnetic Resonance, 10
J. Chikwe, Nana Toyoda, A. Anyanwu, Shinobu Itagaki, N. Egorova, P. Boateng, Ahmed El‐Eshmawi, D. Adams (2017)
Relation of Mitral Valve Surgery Volume to Repair Rate, Durability, and Survival.Journal of the American College of Cardiology
N. Christensen, J. Dahl, R. Carter-Storch, Rine Bakkestrøm, Kurt Jensen, F. Steffensen, E. Søndergaard, L. Videbæk, J. Møller (2016)
Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic StenosisCirculation: Cardiovascular Imaging, 9
R. Suri, J. Vanoverschelde, F. Grigioni, H. Schaff, C. Tribouilloy, J. Aviérinos, A. Barbieri, A. Pasquet, M. Huebner, D. Ruşinaru, A. Russo, H. Michelena, M. Enriquez-Sarano (2013)
Association between early surgical intervention vs watchful waiting and outcomes for mitral regurgitation due to flail mitral valve leaflets.JAMA, 310 6
C. Tribouilloy, M. Enriquez-Sarano, H. Schaff, T. Orszulak, K. Bailey, A. Tajik, R. Frye (1999)
Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications.Circulation, 99 3
M. Dalsgaard, J. Kjaergaard, R. Pecini, K. Iversen, L. Køber, J. Møller, P. Grande, P. Clemmensen, C. Hassager (2009)
Left ventricular filling pressure estimation at rest and during exercise in patients with severe aortic valve stenosis: comparison of echocardiographic and invasive measurements.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 22 4
N. Kawel‐Boehm, A. Maceira, E. Valsangiacomo-Buechel, J. Vogel-Claussen, E. Turkbey, Rupert Williams, S. Plein, Michael Tee, J. Eng, D. Bluemke (2015)
Normal values for cardiovascular magnetic resonance in adults and childrenJournal of Cardiovascular Magnetic Resonance, 17
M. Enriquez-Sarano, J. Aviérinos, D. Messika‐Zeitoun, D. Détaint, M. Capps, V. Nkomo, C. Scott, H. Schaff, A. Tajik (2005)
Quantitative determinants of the outcome of asymptomatic mitral regurgitation.The New England journal of medicine, 352 9
M. Cerqueira, N. Weissman, V. Dilsizian, A. Jacobs, S. Kaul, W. Laskey, D. Pennell, J. Rumberger, T. Ryan, M. Verani (2002)
Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association.Circulation, 105 4
J. Schulz-Menger, D. Bluemke, J. Bremerich, S. Flamm, M. Fogel, M. Friedrich, R. Kim, F. Knobelsdorff-Brenkenhoff, C. Kramer, D. Pennell, S. Plein, E. Nagel (2013)
Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post ProcessingJournal of Cardiovascular Magnetic Resonance, 15
R. Bonow (2013)
Chronic mitral regurgitation and aortic regurgitation: have indications for surgery changed?Journal of the American College of Cardiology, 61 7
P. Supino, J. Borer, K. Schuleri, Anuj Gupta, C. Hochreiter, P. Kligfield, E. Herrold, J. Preibisz (2007)
Prognostic value of exercise tolerance testing in asymptomatic chronic nonischemic mitral regurgitation.The American journal of cardiology, 100 8
P. Lancellotti, C. Tribouilloy, A. Hagendorff, B. Popescu, T. Edvardsen, L. Pierard, L. Badano, J. Zamorano (2013)
Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging.European heart journal cardiovascular Imaging, 14 7
P. Pellikka, S. Nagueh, A. Elhendy, C. Kuehl, S. Sawada (2007)
American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 20 9
R. Rosenhek, F. Rader, U. Klaar, H. Gabriel, M. Krejc, D. Kalbeck, M. Schemper, G. Maurer, H. Baumgartner (2006)
Outcome of Watchful Waiting in Asymptomatic Severe Mitral RegurgitationCirculation, 113
M. Aplin, K. Kyhl, J. Bjerre, N. Ihlemann, J. Greenwood, S. Plein, A. Uddin, N. Tønder, N. Høst, Malin Ahlström, J. Hove, C. Hassager, K. Iversen, N. Vejlstrup, P. Madsen (2016)
Cardiac remodelling and function with primary mitral valve insufficiency studied by magnetic resonance imaging.European heart journal cardiovascular Imaging, 17 8
D. Messika‐Zeitoun, Bruce Johnson, V. Nkomo, J. Aviérinos, T. Allison, C. Scott, A. Tajik, M. Enriquez-Sarano (2006)
Cardiopulmonary exercise testing determination of functional capacity in mitral regurgitation: physiologic and outcome implications.Journal of the American College of Cardiology, 47 12
Rick Nishimura, C. Otto, R. Bonow, B. Carabello, J. Erwin, R. Guyton, P. O'Gara, C. Ruiz, N. Skubas, P. Sorajja, T. Sundt, James Thomas (2014)
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 Practice Guidelines.Circulation, 129 23
E. Picano, P. Pibarot, P. Lancellotti, J. Monin, R. Bonow (2009)
The emerging role of exercise testing and stress echocardiography in valvular heart disease.Journal of the American College of Cardiology, 54 24
J. Magne, P. Lancellotti, L. Pierard (2010)
Exercise-induced changes in degenerative mitral regurgitation.Journal of the American College of Cardiology, 56 4
M. Andersen, M. Ersbøll, J. Bro-Jeppesen, F. Gustafsson, C. Hassager, L. Køber, B. Borlaug, S. Boesgaard, J. Kjærgaard, J. Møller (2012)
Exercise Hemodynamics in Patients With and Without Diastolic Dysfunction and Preserved Ejection Fraction After Myocardial InfarctionCirculation: Heart Failure, 5
M. Guazzi, V. Adams, V. Conraads, M. Halle, A. Mezzani, L. Vanhees, R. Arena, G. Fletcher, D. Forman, D. Kitzman, C. Lavie, J. Myers (2012)
EACPR/AHA Joint Scientific Statement. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations.European heart journal, 33 23
L. Ling, M. Enriquez-Sarano, J. Seward, A. Tajik, H. Schaff, K. Bailey, R. Frye (1996)
Clinical outcome of mitral regurgitation due to flail leaflet.The New England journal of medicine, 335 19
B. Borlaug, R. Nishimura, P. Sorajja, C. Lam, M. Redfield (2010)
Exercise Hemodynamics Enhance Diagnosis of Early Heart Failure With Preserved Ejection FractionCirculation: Heart Failure, 3
E. Wolsk, Rine Bakkestrøm, J. Thomsen, L. Balling, M. Andersen, J. Dahl, C. Hassager, J. Moller, F. Gustafsson (2017)
The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals.JACC. Heart failure, 5 5
S. Uretsky, L. Gillam, R. Lang, F. Chaudhry, E. Argulian, A. Supariwala, S. Gurram, Kavya Jain, Marjorie Subero, James Jang, R. Cohen, S. Wolff (2015)
Discordance between echocardiography and MRI in the assessment of mitral regurgitation severity: a prospective multicenter trial.Journal of the American College of Cardiology, 65 11
L. Bertelsen, J. Svendsen, L. Køber, K. Haugan, S. Højberg, C. Thomsen, N. Vejlstrup (2016)
Flow measurement at the aortic root - impact of location of through-plane phase contrast velocity mappingJournal of Cardiovascular Magnetic Resonance, 18
A. Vahanian, O. Alfieri, F. Andreotti, M. Antunes, G. Barón-Esquivias, H. Baumgartner, M. Borger, T. Carrel, M. Bonis, A. Evangelista, V. Falk, B. Iung, P. Lancellotti, L. Pierard, S. Price, H. Schäfers, G. Schuler, J. Stȩpińska, K. Swedberg, J. Takkenberg, U. Oppell, S. Windecker, J. Zamorano, M. Zembala (2012)
Guidelines on the management of valvular heart disease (version 2012).European heart journal, 33 19
Rick Nishimura, C. Otto, R. Bonow, B. Carabello, J. Erwin, L. Fleisher, H. Jneid, M. Mack, Christopher McLeod, P. O'Gara, V. Rigolin, T. Sundt, Annemarie Thompson (2017)
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.Journal of the American College of Cardiology, 70 2
Background— In severe asymptomatic primary mitral valve regurgitation without risk factors, surgery strategy is controversial. We sought to clarify whether being symptomatic corresponds to the hemodynamic burden and reduced exercise capacity. A better understanding of this may contribute to optimize timing of surgery. Methods and Results— Subjects with asymptomatic (New York Heart Association functional class I, n=29) or symptomatic (New York Heart Association functional class II and III, n=28) significant primary mitral valve regurgitation (effective regurgitant orifice, ≥0.30 cm2; left ventricular ejection fraction, >60%) were included. Right heart catheterization during rest and exercise, echocardiography, magnetic resonance imaging, and peak oxygen consumption test was performed. Symptomatic subjects had significantly higher pulmonary capillary wedge pressure at rest (14±4 versus 11±3 mm Hg; P=0.003) and at maximal exercise (30±6 versus 25±7 mm Hg; P=0.02) and higher mean pulmonary artery pressure (PAP) at rest (22±7 versus 18±4 mm Hg; P=0.005) and maximal exercise (46±8 versus 39±7 mm Hg; P=0.005) than asymptomatic subjects. Among asymptomatic subjects with normal resting value, exercise testing revealed a systolic PAP >60 mm Hg in 34%. Also the reverse response with minimal increase in pulmonary capillary wedge pressure and mean PAP during exercise was seen, especially in asymptomatic subjects. Among symptomatic subjects, we found a significant inverse correlation between resting mean PAP and left ventricular ejection fraction (r=−0.52; P=0.02) and right ventricular ejection fraction (r=−0.67; P<0.01). Peak oxygen consumption was equal and normal in both groups and correlated with left ventricular stroke volume but not with pulmonary capillary wedge pressure. Conclusions— Symptoms in patients with severe mitral valve regurgitation relate to congestion (pulmonary capillary wedge pressure and PAP), but not to peak oxygen consumption, which is determined by forward left ventricular stroke volume. Exercise testing reveals a higher mitral valve regurgitation burden in apparently asymptomatic patients. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT02961647.
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: Feb 1, 2018
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