Abstract
Atrioventricular regurgitation is frequent in the setting of heart failure. It is due to atrial and ventricular remodelling, as well as rhythmic disturbances and loss of synchrony. Once atrioventricular regurgitation develops, it can aggravate the underlying heart failure, and further participate and aggravate its own severity. Its presence is therefore concomitantly a surrogate of advance disease and a predictor of mortality. Heart failure management, including medical therapy, cardiac resynchronization therapy, and restoration of sinus rhythm, are the initial steps to reduce atrioventricular regurgitation. In the current review, we analyse the current data assessing the epidemiology, pathophysiology, and impact of non-valvular intervention on atrioventricular regurgitation including medical treatment, cardiac resynchronization and atrial fibrillation ablation.
Highlights
INTRODUCTIONWhether mitral or tricuspid, is highly prevalent in the general population, and in the setting of heart failure (HF)
Chronic atrioventricular valves regurgitation, whether mitral or tricuspid, is highly prevalent in the general population, and in the setting of heart failure (HF)
Data from the prospective European Society of Cardiology Heart Failure Long-Term (ESC-HF-LT) Registry estimate that moderate-to-severe secondary Mitral regurgitation (MR) is present in 36% of patients with HF with reduced ejection fraction (HFrEF), 28% with HF with mid-range ejection fraction, and 20% with HF with preserved ejection fraction [3]
Summary
Whether mitral or tricuspid, is highly prevalent in the general population, and in the setting of heart failure (HF). Mitral regurgitation (MR) is currently the most common type of moderate-to-severe valve disease in the general adult population, partly due to the increase in the prevalence of treated cardiomyopathies and HF [1]. Data from the prospective European Society of Cardiology Heart Failure Long-Term (ESC-HF-LT) Registry estimate that moderate-to-severe secondary MR is present in 36% of patients with HF with reduced ejection fraction (HFrEF), 28% with HF with mid-range ejection fraction, and 20% with HF with preserved ejection fraction [3]. The presence of secondary MR in patients with HFrEF is associated with HF symptoms, increased hospitalisation rates, and worse prognosis. In a large cohort of patients with HFrEF, increasing TR severity was independently associated with considerably worse prognosis. The independent impact of TR on mortality was sustained whatever the ejection fraction was [8]
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