Mitral valve stenosis in the current era: a changing landscape. Issue 11 (7th November 2022)

• Record Type: Journal Article
• Authors: Giannini, Cristina; Mazzola, Matteo; Pugliese, Nicola Riccardo; Petronio, Anna Sonia
• Is Part Of: Journal of cardiovascular medicine. Volume 23:Issue 11(2022)
• Page Start: 701
• Page End: 709
• Publication Date: 2022-11-07
• Subjects: mitral annulus calcification -- mitral stenosis -- rheumatic fever; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000001384
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : Mitral stenosis results from haemodynamic obstruction at the mitral valve level because of structural abnormalities of the valve apparatus, leading to increased resistance to the transmitral flow. Although rheumatic fever remains the predominant cause of mitral stenosis worldwide, other causes are increasingly relevant in the developed countries with degenerative mitral stenosis (DMS) because of mitral annulus calcification (MAC) becoming growingly prevalent in industrialized countries with higher life expectancy. Rheumatic mitral stenosis (RMS) and DMS display dramatic differences in pathophysiology, prognosis, and disease progression. Furthermore, to date, robust evidence regarding the management of DMS because of MAC is lacking. Nevertheless, new diagnostic techniques and catheter-based interventions are changing this landscape and paving the way to a significant reduction in DMS-related morbidity and mortality. Here we briefly review the current knowledge on the pathophysiology, diagnosis and treatment of DMS and RMS, underscoring the current diagnostic and therapeutic pathways, as well as persisting uncertainties and perspectives.