Improving Phenotypic Classification and Prediction of Treatment Outcomes in Patients with Non-ischemic Cardiomyopathy and Functional Mitral RegurgitationProject Summary
Functional mitral regurgitation (FMR) portends a bleak prognosis and is a common
consequence of ischemic and non-ischemic cardiomyopathy (ICM, NICM), where adverse
annular and left ventricular (LV) remodeling and/or infarction alters mitral valve (MV) function.
Prior studies demonstrate significant increases in mortality risk as severity of FMR increases;
mortality rates range from 15-40% at 1 year. Furthermore, as the prevalence of heart failure
(HF) is rising, FMR is projected to double from over 2 million patients in 2000 to over 4 million
patients in the United States by 2030. Defining FMR severity, optimal timing of intervention, and
most appropriate method for intervention remain controversial. Recently, MITRA-FR and
COAPT trials demonstrated contrasting survival benefit with percutaneous MV repair,
demonstrating the importance and need for more optimal selection criteria. Currently, the patient
selection criteria for Mitraclip therapy are solely based on MV anat
Mechanism of Eccentric Cardiomyocyte Hypertrophy Secondary to Mitral RegurgitationValvular heart disease represents a major public health problem worldwide. The incidence of valvular heart
disease increases with age, and it is estimated that about 15% of the population above the age of 75 years
suffer from some form of significant valvular disorder. Mitral regurgitation (MR) is the most frequent form of
valvular heart diseases, where it is estimated that moderate and severe MR occurs at a frequency of 1.7% as
adjusted to the US adult population, and up to 5% of the population in Europe have significant mitral valve
disease. The natural history of chronic MR is characterized by a compensated hemodynamic state in its early
phases, followed by a gradual progressive left ventricular (LV) remodeling and eccentric hypertrophy resulting
in heart failure. MR patients with depressed systolic function can present a difficult management dilemma;
corrective valve surgery is not recommended, and medical therapy is ineffective in preventing LV dysfunction.
It should perhaps be no
Reciprocal effects between scaffold geometry and ventricular vortex flow on viability and performance of tissue-engineered mitral valvePROJECT SUMMURY/ABSTRACT
Valvular heart disease (VHD) is the third-most common cause of heart problems in the United States, with
mitral valve disease as the second-most common VHD after aortic stenosis. Mitral valve disease can cause
many complications if left untreated and is more common in younger patients, in whom bioprosthetic heart
valves (BHVs) are prone to faster degeneration. An ultimate solution for younger patients with long life
expectancy is a living tissue valve, although exploratory studies for tissue-engineered heart valve (TEHVs)
have yet to satisfy the regulatory requirements for clinical use. In preclinical studies, current TEHVs have been
unable to adjust their composition to withstand the hemodynamic loads to which they would be exposed, and
their leaflets were found to shrink due to their degradable scaffolds, which led to poor leaflet coaptation,
followed by progressive regurgitation and valvular insufficiency.
The native mitral valve is bileaflet, with a saddle-