Papillary muscle dyssynchrony: what is the optimal cut-off value?

Abstract

We appreciate the useful comments by Cabrera-Bueno et al. underscoring the importance of mitral regurgitation (MR) in patients with dilated cardiomyopathy (DCM). Cardiac resynchronization therapy (CRT) improves functional MR during the acute and chronic phase of heart failure by improving the coordination of the left ventricular segments and papillary muscle contractions.1,2. However, MR volumes of the patients with minimal papillary muscle dyssynchrony did not improve following CRT.2 The best echocardiographic cut-off value to predict significant papillary muscle dyssynchrony, which in turn, would help patient selection for CRT is still unknown. The papillary muscles usually get closer to each …