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Functional mitral regurgitation and heart failure with preserved ejection fraction: clinical implications and management.
Journal of Cardiac Failure 2024 March 23
Heart failure with preserved ejection fraction (HFpEF) is highly prevalent and associated with worse cardiovascular outcomes. The pathophysiology of HFpEF mostly relies on the development of elevated left ventricle filling pressure, diastolic dysfunction, atrial dilatation and impairment. This dynamic process may eventually lead to the development of functional mitral regurgitation, characterized by mitral annular dilatation and consequent leaflet remodelling, in the context of preserved left ventricular ejection fraction. These observations highlight the possible common pathophysiology of mitral regurgitation and HFpEF. However, less is known about the prevalence and the clinical value of mitral regurgitation in the context of heart failure with preserved ejection fraction. This review aims to provide an overview about the association and interplay between functional mitral regurgitation and HFpEF, discuss the underlying mechanisms that are common to these diseases, and summarize potential targeted pharmacological treatments.
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