Different phenotypes of mitral regurgitation in patients with right apical ventricular pacing: An echocardiographic approach in a heterogeneity of clinical scenario

The right ventricular (RV) apical pacing causes a dyssynchronous activation of the left ventricle and the papillary muscles, which determines the decline of the left ventricular ejection fraction (LVEF) in addition to inadequate closure of the valvular apparatus with the presence of different degree...

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Bibliographic Details
Authors: Chango Azanza, Diego Xavier, Munín, Martín Alejandro, Raggio, Ignacio, Perea, Gabriel, Carbajales, Justo
Format: article
Status:Published version
Publication Date:2021
Country:Perú
Institution:Instituto Nacional Cardiovascular
Repository:Archivos peruanos de cardiología y cirugía cardiovascular
Language:Spanish
OAI Identifier:oai:apcyccv.org.pe:article/130
Online Access:https://apcyccv.org.pe/index.php/apccc/article/view/130
Access Level:Open access
Keyword:Insuficiencia mitral
Estimulación cardiaca artificial
Ecocardiografía transtorácica
Mitral regurgitation
Cardiac pacing
Transthoracic echocardiography
Description
Summary:The right ventricular (RV) apical pacing causes a dyssynchronous activation of the left ventricle and the papillary muscles, which determines the decline of the left ventricular ejection fraction (LVEF) in addition to inadequate closure of the valvular apparatus with the presence of different degrees of mitral valve regurgitation. The study of this condition is relevant in clinical decision-making to define patients who benefit from cardiac resynchronization for the relief of symptomatic mitral regurgitation. However, there is a wide heterogeneity of conditions and pathologies that can coexist with different degrees of cardiomyopathies in these patients, which makes etiological determination challenging and worsens the clinical course. The transthoracic echocardiography allows us the comprehensive assessment of mitral valve regurgitation and ventricular function parameters as well as mechanical dyssynchrony as a result of the artificial pacing.