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The Mitral Valve Disease

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Valvular Heart Disease in Clinical Practice

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Abstract

Common causes of heart valve disease are rheumatic, calcific and less frequently congenital. With the significant decline in the incidence of rheumatic fever in Europe and North America over the last 50 years a parallel shift in the etiology of valve disease occurred with a fall in the incidence of rheumatic valve disease and an increase in the prevalence of degenerative valve pathology. Rheumatic valve disease, however, remains prevalent in the developing countries in Africa, South America and parts of Asia, particularly in areas with limited clinical services. The commonest valve involved with rheumatic pathology is the mitral valve, but this is not exclusive since aortic and tricuspid valves can also be involved [1]. The apparent contemporary increase in the diagnosis of valve disease results from the global increase in age of the population as well as the easy availability and routine use of echocardiography in cardiology clinics

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References

  1. National Center for Health Statistics: Vital and Health Statistics: Series 13, Hyattsville, MD. Centers for Disease Control and Prevention 1985–1999. 2006. Ref Type: Internet Communication.

    Google Scholar 

  2. Zhang W, Chung CS, Shmuylovich L, Kovacs SJ. Viewpoint: is left ventricular volume during diastasis the real equilibrium volume and what is its relationship to diastolic suction. J Appl Physiol 2007 Sep 27.

    Google Scholar 

  3. Kilner PJ, Henein MY, Gibson DG. Our tortuous heart in dynamic mode – an echocardiographic study of mitral flow and movement in exercising subjects. Heart Vessels 1997; 12(3): 103–110.

    Article  CAS  PubMed  Google Scholar 

  4. Henein M, Lindqvist P, Francis D, Morner S, Waldenstrom A, Kazzam E. Tissue Doppler analysis of age-dependency in diastolic ventricular behaviour and filling: a cross-sectional study of healthy hearts (the Umea General Population Heart Study). Eur Heart J 2002; 23(2):162–171.

    Article  CAS  PubMed  Google Scholar 

  5. Waller BF. Etiology of mitral stenosis and pure mitral regurgitation. In: Waller BF, editor. Pathology of the Heart and Great Vessels. New York: Churchill Livingstone, 1988; 101–148.

    Google Scholar 

  6. Moreyra AE, Wilson AC, Deac R, et al. Factors associated with atrial fibrillation in patients with mitral stenosis: a cardiac catheterization study. Am Heart J 1998; 135(1):138–145.

    Article  CAS  PubMed  Google Scholar 

  7. Alfonso F, Macaya C, Hernandez R, et al. Percutaneous mitral valvuloplasty with severe pulmonary artery hypertension. Am J Cardiol 1993; 72(3):325–330.

    Article  CAS  PubMed  Google Scholar 

  8. Wolf PA, Dawber TR, Thomas HE Jr., et al. Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Neurology 1978; 28(10):973–977.

    CAS  PubMed  Google Scholar 

  9. Hwang JJ, Li YH, Lin JM, et al. Left atrial appendage function determined by transesophageal echocardiography in patients with rheumatic mitral valve disease. Cardiology 1994; 85(2): 121–128.

    Article  CAS  PubMed  Google Scholar 

  10. Alpert JS. Mitral stenosis. In: Alpert JS, Dalen JE, Rahimtoola SH, editors. Valvular Heart Disease. Philadelphia: Lippincott Williams & Wilkins, 1999.

    Google Scholar 

  11. Smith MD, Handshoe R, Handshoe S, Kwan OL, DeMaria AN. Comparative accuracy of two-dimensional echocardiography and Doppler pressure half-time methods in assessing severity of mitral stenosis in patients with and without prior commissurotomy. Circulation 1986; 73(1):100–107.

    CAS  PubMed  Google Scholar 

  12. Kawahara T, Yamagishi M, Seo H, Mitani M, Nakatani S, Beppu S, et al. Application of Doppler color flow imaging to determine valve area in mitral stenosis. J Am Coll Cardiol 1991; 18(1):85–92.

    Article  CAS  PubMed  Google Scholar 

  13. Deng YB, Matsumoto M, Wang XF, Liu L, Takizawa S, Takekoshi N, et al. Estimation of mitral valve area in patients with mitral stenosis by the flow convergence region method: selection of aliasing velocity. J Am Coll Cardiol 1994; 24(3):683–689.

    Article  CAS  PubMed  Google Scholar 

  14. Nishimura RA, Rihal CS, Tajik AJ, Holmes DR, Jr. Accurate measurement of the transmitral gradient in patients with mitral stenosis: a simultaneous catheterization and Doppler echocardiographic study. J Am Coll Cardiol 1994; 24(1):152–158.

    Article  CAS  PubMed  Google Scholar 

  15. Hatle L, Angelsen B, Tromsdal A. Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound. Circulation 1979; 60(5):1096–1104.

    CAS  PubMed  Google Scholar 

  16. Hatle L, Angelsen BA. Doppler Ultrasound in Cardiology. 2nd ed. Philadelphia: Lea & Febiger, 1985.

    Google Scholar 

  17. Nakatani S, Masuyama T, Kodama K, Kitabatake A, Fujii K, Kamada T. Value and limitations of Doppler echocardiography in the quantification of stenotic mitral valve area: comparison of the pressure half-time and the continuity equation methods. Circulation 1988; 77(1):78–85.

    CAS  PubMed  Google Scholar 

  18. Rothlisberger C, Essop MR, Skudicky D, et al. Results of percutaneous balloon mitral valvotomy in young adults. Am J Cardiol 1993; 72(1):73–77.

    Article  CAS  PubMed  Google Scholar 

  19. Horstkotte D, Niehues R, Strauer BE. Pathomorphological aspects, aetiology and natural history of acquired mitral valve stenosis. Eur Heart J 1991; 12(Suppl-B):55–60.

    PubMed  Google Scholar 

  20. Sueda T, Imai K, Ishii O, et al. Efficacy of pulmonary vein isolation for the elimination of chronic atrial fibrillation in cardiac valvular surgery. Ann Thorac Surg 2001; 71(4):1189–1193.

    Article  CAS  PubMed  Google Scholar 

  21. Jatene MB, Marcial MB, Tarasoutchi F, et al. Influence of the maze procedure on the treatment of rheumatic atrial fibrillation – evaluation of rhythm control and clinical outcome in a comparative study. Eur J Cardiothorac Surg 2000; 7(2):117–124.

    Article  Google Scholar 

  22. Abascal VM, Wilkins GT, O'Shea JP, Choong CY, Palacios IF, Thomas JD, et al. Prediction of successful outcome in 130 patients undergoing percutaneous balloon mitral valvotomy. Circulation 1990; 82(2):448–456.

    CAS  PubMed  Google Scholar 

  23. Palacios IF, Block PC, Wilkins GT, Weyman AE. Follow-up of patients undergoing percutaneous mitral balloon valvotomy: analysis of factors determining restenosis. Circulation 1989; 79(3):573–579.

    CAS  PubMed  Google Scholar 

  24. Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J 1988; 60(4):299–308.

    Article  CAS  PubMed  Google Scholar 

  25. Detter C, Fischlein T, Feldmeier C, et al. Mitral commissurotomy, a technique outdated? Long-term follow-up over a period of 35 years. Ann Thorac Surg 1999 Dec; 68(6):2112–2118.

    Article  CAS  PubMed  Google Scholar 

  26. Choudhary SK, Dhareshwar J, Govil A, Airan B, Kumar AS. Open mitral commissurotomy in the current era: indications, technique and results. Ann Thorac Surg 2003 Jan; 75(1):41–46.

    Article  PubMed  Google Scholar 

  27. Chauvaud S, Waldmann T, d’Attellis N, et al. Homograft replacement of the mitral valve in young recipients: mid-term results. Eur J Cardiothorac Surg 2003 April; 23(4):560–566.

    Article  CAS  PubMed  Google Scholar 

  28. Kumar AS, Choudhary SK, Mathur A, et al. Homograft mitral valve replacement: five years' results. J Thorac Cardivasc Surg 2000 September; 120(3):450–458.

    Article  CAS  Google Scholar 

  29. Dahan M, Paillole C, Martin D, et al. Determinants of stroke volume response to exercise in patients with mitral stenosis: a Doppler echocardiographic study. J Am Coll Cardiol 1993; 21(2):384–389.

    Article  CAS  PubMed  Google Scholar 

  30. Sharma SK, Seckler J, Israel DH, et al. Clinical, angiographic and anatomic findings in acute severe ischemic mitral regurgitation. Am J Cardiol 1992; 70(3):277–280.

    Article  CAS  PubMed  Google Scholar 

  31. Lehmann KG, Francis CK, Sheehan FH, et al. Effect of thrombolysis on acute mitral regurgitation during evolving myocardial infarction: experience from the Thrombolysis in Myocardial Infarction (TIMI) Trial. J Am Coll Cardiol 1993; 22(3): 714–719.

    Article  CAS  PubMed  Google Scholar 

  32. Gula G, Yacoub MH. Surgical correction of complete rupture of the anterior papillary muscle. Ann Thorac Surg 1981; 32(1): 88–91.

    Article  CAS  PubMed  Google Scholar 

  33. Rankin JS, Hickey MS, Smith LR, et al. Current management of mitral valve incompetence associated with coronary artery disease. J Card Surg 1989; 4(1):25–42.

    Article  CAS  PubMed  Google Scholar 

  34. Kihara Y, Sasayama S, Miyazaki S, et al. Role of the left atrium in adaptation of the heart to chronic mitral regurgitation in conscious dogs. Circ Res 1988; 62(3):543–553.

    CAS  PubMed  Google Scholar 

  35. Davison G, Greenland P. Predictors of left atrial thrombus in mitral valve disease. J Gen Intern Med 1991; 6(2):108–112.

    Article  CAS  PubMed  Google Scholar 

  36. Devereux RB, Kramer-Fox R, Shear MK, et al. Diagnosis and classification of severity of mitral valve prolapse: methodologic, biologic, and prognostic considerations. Am Heart J 1987; 113(5):1265–1280.

    Article  CAS  PubMed  Google Scholar 

  37. Devereux RB. Recent developments in the diagnosis and management of mitral valve prolapse. Curr Opin Cardiol 1995; 10(2):107–116.

    Article  CAS  PubMed  Google Scholar 

  38. Virmani R, Atkinson JB, Forman MB. The pathology of mitral valve prolapse. Herz 1988; 13(4):215–226.

    CAS  PubMed  Google Scholar 

  39. Renteria VG, Ferrans VJ, Jones M, et al. Intracellular collagen fibrils in prolapsed (``floppy") human atrioventricular valves. Lab Invest 1976; 35(5):439–443.

    CAS  PubMed  Google Scholar 

  40. Weiss AN, Mimbs JW, Ludbrook PA, et al. Echocardiographic detection of mitral valve prolapse: exclusion of false positive diagnosis and determination of inheritance. Circulation 1975; 52(6):1091–1096.

    CAS  PubMed  Google Scholar 

  41. Duren DR, Becker AE, Dunning AJ. Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. J Am Coll Cardiol 1988; 11(1):42–47.

    Article  CAS  PubMed  Google Scholar 

  42. Ling LH, Enriquez-Sarano M, Seward JB, et al. Clinical outcome of mitral regurgitation due to flail leaflet. N Engl J Med 1996; 335(19):1417–1423.

    Article  CAS  PubMed  Google Scholar 

  43. Ross J, Jr. Left ventricular function and the timing of surgical treatment in valvular heart disease. Ann Intern Med 1981; 94(4 Pt 1):498–504.

    PubMed  Google Scholar 

  44. Grigioni F, Enriquez-Sarano M, Ling LH, et al. Sudden death in mitral regurgitation due to flail leaflet. J Am Coll Cardiol 1999; 34(7):2078–2085.

    Article  CAS  PubMed  Google Scholar 

  45. Devereux RB, Kramer-Fox R, Kligfield P. Mitral valve prolapse: causes, clinical manifestations, and management. Ann Intern Med 1989; 111(4):305–317.

    CAS  PubMed  Google Scholar 

  46. Dajani AS, Taubert KA, Wilson W, et al. Prevention of bacterial endocarditis: recommendations by the American Heart Association. JAMA 1997; 77(22):1794–1801.

    Article  Google Scholar 

  47. Suma H, Isomura T, Horii T, Nomuram, F. Septal anterior ventricular exclusion procedure for idiopathic dilated cardiomyopathy. Ann Thorac Surg 2006 October; 82(4):1344–1348

    Article  PubMed  Google Scholar 

  48. Breithardt OA, Sinha AM, Schwammenthal E, et al. Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure. J Am Coll Cardiol 2003; 41(5):765–770.

    Article  PubMed  Google Scholar 

  49. 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): 1201–1205.

    Article  CAS  PubMed  Google Scholar 

  50. Dujardin KS, Enriquez-Sarano M, Bailey KR, et al. Effect of losartan on degree of mitral regurgitation quantified by echocardiography. Am J Cardiol 2001; 87(5):570–576.

    Article  CAS  PubMed  Google Scholar 

  51. Castello R, Lenzen P, Aguirre F, Labovitz AJ. Quantitation of mitral regurgitation by transesophageal echocardiography with Doppler color flow mapping: correlation with cardiac catheterization. J Am Coll Cardiol 1992; 19(7):1516–1521.

    Article  CAS  PubMed  Google Scholar 

  52. Upton MT, Gibson DG. The study of left ventricular function from digitized echocardiograms. Prog Cardiovasc Dis 1978; 20(5):359–384.

    Article  CAS  PubMed  Google Scholar 

  53. Ishitoya H. Recovery of left ventricular function afte rmitral valve replacement for chronic mitral regurgitation: optimal timing of operation according to long-term recovery. J Cardiol 2000 July; 36(1):37–44.

    CAS  PubMed  Google Scholar 

  54. Helmcke F, Nanda NC, Hsiung MC, Soto B, Adey CK, Goyal RG, et al. Color Doppler assessment of mitral regurgitation with orthogonal planes. Circulation 1987; 75(1):175–183.

    CAS  PubMed  Google Scholar 

  55. Miyatake K, Izumi S, Okamoto M, Kinoshita N, Asonuma H, Nakagawa H, et al. Semiquantitative grading of severity of mitral regurgitation by real-time two-dimensional Doppler flow imaging technique. J Am Coll Cardiol 1986; 7(1):82–88.

    Article  CAS  PubMed  Google Scholar 

  56. Spain MG, Smith MD, Grayburn PA, Harlamert EA, DeMaria AN. Quantitative assessment of mitral regurgitation by Doppler color flow imaging: angiographic and hemodynamic correlations. J Am Coll Cardiol 1989; 13(3):585–590.

    Article  CAS  PubMed  Google Scholar 

  57. Eren M, Eksik A, Gorgulu S, Norgaz T, Dagdeviren B, Bolca O, et al. Determination of vena contracta and its value in evaluating severity of aortic regurgitation. J Heart Valve Dis 2002; 11(4):567–575.

    PubMed  Google Scholar 

  58. Klein AL, Obarski TP, Stewart WJ, Casale PN, Pearce GL, Husbands K, et al. Transesophageal Doppler echocardiography of pulmonary venous flow: a new marker of mitral regurgitation severity. J Am Coll Cardiol 1991; 18(2):518–526.

    Article  CAS  PubMed  Google Scholar 

  59. Nishimura RA, Tajik AJ. Determination of left-sided pressure gradients by utilizing Doppler aortic and mitral regurgitant signals: validation by simultaneous dual catheter and Doppler studies. J Am Coll Cardiol 1988; 11(2):317–321.

    Article  CAS  PubMed  Google Scholar 

  60. Ren JF, Kotler MN, DePace NL, Mintz GS, Kimbiris D, Kalman P, et al. Two-dimensional echocardiographic determination of left atrial emptying volume: a noninvasive index in quantifying the degree of nonrheumatic mitral regurgitation. J Am Coll Cardiol 1983; 2(4):729–736.

    Article  CAS  PubMed  Google Scholar 

  61. Bargiggia GS, Tronconi L, Sahn DJ, Recusani F, Raisaro A, De Servi S, et al. A new method for quantitation of mitral regurgitation based on color flow Doppler imaging of flow convergence proximal to regurgitant orifice. Circulation 1991; 84(4): 1481–1489.

    CAS  PubMed  Google Scholar 

  62. Hochreiter C, Niles N, Devereux RB, et al. Mitral regurgitation: relationship of noninvasive descriptors of right and left ventricular performance to clinical and hemodynamic findings and to prognosis in medically and surgically treated patients. Circulation 1986; 73(5):900–912.

    CAS  PubMed  Google Scholar 

  63. Smedira NG, Selman R, Cosgrove DM, et al. Repair of anterior leaflet prolapse: chordal transfer is superior to chordal shortening. J Thorac Cardiovasc Surg 1996; 112(2):287–291.

    Article  CAS  PubMed  Google Scholar 

  64. Enriquez-Sarano M, Tajik AJ, Schaff HV, et al. Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation 1994; 90(2):830–837.

    CAS  PubMed  Google Scholar 

  65. Tribouilloy CM, Enriquez-Sarano M, Schaff HV, et al. Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications. Circulation 1999; 99(3):400–405.

    CAS  PubMed  Google Scholar 

  66. Hendren WG, Nemec JJ, Lytle BW, et al. Mitral valve repair for ischemic mitral insufficiency. Ann Thorac Surg 1991; 52(6):1246–1251.

    Article  CAS  PubMed  Google Scholar 

  67. Zile MR, Gaasch WH, Carroll JD, et al. Chronic mitral regurgitation: predictive value of preoperative echocardiographic indexes of left ventricular function and wall stress. J Am Coll Cardiol 1984; 3(2 Pt 1):235–242.

    Article  CAS  PubMed  Google Scholar 

  68. Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines 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 (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 2006; 48(3):e1–148.

    Article  PubMed  Google Scholar 

  69. Czer LS, Maurer G, Bolger AF, De Robertis M, Resser KJ, Kass RM, et al. Intraoperative evaluation of mitral regurgitation by Doppler color flow mapping. Circulation 1987; 76(3 Pt 2):III108–III116.

    CAS  PubMed  Google Scholar 

  70. Reichert SL, Visser CA, Moulijn AC, Suttorp MJ, vd Brink RB, Koolen JJ, et al. Intraoperative transesophageal color-coded Doppler echocardiography for evaluation of residual regurgitation after mitral valve repair. J Thorac Cardiovasc Surg 1990; 100(5):756–761.

    CAS  PubMed  Google Scholar 

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  1. Umeà University Hospital Heart Centre, Sweden

    Michael Henein

  2. Royal Brompton Hospital, Imperial College London, UK

    John Pepper MD (Professor of Cardiothoracic Surgery)

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  1. Umea Heart Centre, Umea University, Sweden

    Michael Y. Henein (Consultant Cardiologist) (Consultant Cardiologist)

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Henein, M., Pepper, J. (2009). The Mitral Valve Disease. In: Henein, M.Y. (eds) Valvular Heart Disease in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84800-275-3_1

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  • DOI: https://doi.org/10.1007/978-1-84800-275-3_1

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