Refluxo Mitral: Como, quando e onde medir?


.
Dynamic nature of functional mitral regurgitation
Eur J Echocardiogr (2010) 11 (10): i11-i17.

As described above, functional MR results from a complex interplay of geometric and contractile abnormalities and varies substantially not only with ventricular loading conditions but also during the cardiac cycle
.
Pitfalls in the quantitative echocardiographic assessment of functional mitral regurgitation
.
As already described, the geometric distortions underlying functional MR tend to result in variable failure of coaptation along the closure line of the valve such that the regurgitant orifice is elliptical or slit-like as opposed to circular.
.
The dynamic nature of functional MR is a major challenge to quantification using standard flow convergence methods involving the measurement of proximal isovelocity area.
.
The volumetric method where aortic forward stroke volume is subtracted from total stroke volume through the mitral annulus to obtain the mitral regurgitant volume is an alternative
.
Aos poucos, métodos instantâneos vão sendo comparados a métodos interativos e de remodelamento.
.

Dilatação do Átrio Esquerdo: O mais básico do Eco ainda é um mistério


.
These data confirm the notion that significant functional MR requires LV remodeling–generated leaflet distortion in addition to annular enlargement. Indeed, progression or recurrence after annuloplasty for functional MR relates modestly to annular dilatation but strongly to mitral leaflet tenting that is a function of ventricular remodeling, papillary muscle displacement, and increased chordal traction
.
AQUI COMPLETO
.
Sinto falta desse tipo de discussão em um congresso de Eco.
.
Não é o local para encontro dos estudiosos do tema?
.
Acaba sendo mais fácil explicar uma nova tecnologia ou procedimento do que elucidar as causas de velhos achados…
.