Real-time 3-dimensional dynamics of functional mitral regurgitation: a prospective quantitative and mechanistic study.

Background: Three-dimensional transthoracic echocardiography (3D-TTE) with dedicated software permits quantification of mitral annulus dynamics and papillary muscle motion throughout the cardiac cycle.

Methods And Results: Mitral apparatus 3D-TTE was acquired in controls (n=42), patients with left ventricle dysfunction and functional mitral regurgitation (LVD-FMR; n=43) or without FMR (LVD-noMR, n=35). Annulus in both normal and LVD-noMR subjects displayed saddle shape accentuation in early-systole (ratio of height to intercommissural diameter, 10.

Mitral valve prolapse with mid-late systolic mitral regurgitation: pitfalls of evaluation and clinical outcome compared with holosystolic regurgitation.

Background: Mitral regurgitation (MR) of mitral valve prolapse predominates in late systole but may be holosystolic or purely mid-late systolic, but the impact of MR timing on MR left ventricular and left atrial consequences and outcome is unknown. Whether effective regurgitant orifice (ERO) by the flow convergence method is similarly linked to outcome in mid-late systolic MR and holosystolic MR is uncertain.

Methods And Results: We comprehensively and prospectively quantified MR in 111 patients with mitral valve prolapse and mid-late systolic MR and matched them to 90 patients with mitral valve prolapse and holosystolic MR for age, gender, atrial fibrillation, ejection fraction, and ERO (flow convergence).

Echocardiographic findings in stable outpatients with properly functioning HeartMate II left ventricular assist devices.

Background: Continuous-flow left ventricular assist devices (LVADs) have become part of the standard of care for the treatment of advanced heart failure. However, knowledge of normal values for transthoracic echocardiographic examination and measurements in these patients are lacking.

Methods: All transthoracic echocardiographic examinations in 63 consecutive patients, performed 90 and 180 days after surgery with the implantation of a HeartMate II continuous-flow LVAD between February 2007 and January 2010, were retrospectively analyzed.

[Mechanical circulatory supports. Advanced stage of heart failure].

Heart failure is considering one of the most prevalent diseases in recent years. Despite advances in the treatment with new drugs and devices such as implantable defibrillator and cardiac resynchronization therapy, the progression in heart failure leads to deterioration in the quality of life, frequent hospitalizations and high mortality rates. Advanced stage of this disease remains heart transplantation for treatment choice, although is not the adequate therapy for all the patients.

Progress in the treatment of severe mitral regurgitation.

Organic mitral regurgitation (MR) is prevalent in the general population. Disease progression, involving potentially irreversible left ventricular dysfunction, implies a poor prognosis for patients who do not receive appropriate treatment. Immediate rescue surgery is indicated in those with severe MR in whom subclinical left ventricular dysfunction is suggested by echocardiographic measurements or the presence of symptoms, however minor.