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摘要: 功能性(或继发性)二尖瓣反流是由于左心扩张导致二尖瓣前后叶闭合不全，它常与射血分数减低型心力衰竭(心衰)合并存在，并与心脏重塑形成恶性循环，加快心衰进程导致不良预后。目前，指南推荐的优化药物和器械治疗对功能性二尖瓣反流的规范化管理至关重要。已有证据显示在多学科心脏团队共同决策下经导管二尖瓣缘对缘修复术能够进一步改善患者预后。Abstract: Functional(or secondary) mitral regurgitation(FMR or SMR) occurs frequently in heart failure(HF) with reduced left ventricular(LV) ejection fraction, resulting from LV remodeling that prevents coaptation of the valve leaflets. FMR contributes to progression of HF and confers worse prognosis. Optimization of pharmacological and device therapy according to guideline recommendations play a key roll for management. Evidence concerning transcatheter mitral edge-to-edge repair could improve patients'outcomes based on decision by Heart Teams.
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图 2 根据二尖瓣瓣叶运动情况的Carpentier分型
Figure 2. Carpentier classification of mitral valve regurgitation
图 3 HF合并FMR的多学科治疗管理
Figure 3. Management of patients with HF and FMR based on multidisciplinary Heart Team approach
图 5 EROA和LVEDV与左心室重塑“不成比例”、“成比例”和“非严重”的FMR之间的关系
Figure 5. Relationship between EROA and LVEDV illustrating domains on"Disproportionately Severe", "Proportionately Severe", and"Nonsevere"FMR
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