Key result
Degenerative mitral stenosis due to mitral annulus calcification is increasingly prevalent in developed countries, presenting distinct pathophysiological differences from rheumatic mitral stenosis.
Why the study?
Degenerative mitral stenosis is increasingly prevalent in developed countries, differs fundamentally from rheumatic mitral stenosis, and lacks robust management evidence.
This review underscores the shifting epidemiology of mitral stenosis towards degenerative causes in developed nations and highlights the potential of emerging diagnostic and catheter-based therapeutic strategies.
Alerts clinicians to rising degenerative mitral stenosis; leaves open tailored therapies distinct from rheumatic disease.
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.
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Giannini et al. (2022) conducted a review in Mitral valve stenosis. Degenerative mitral stenosis due to mitral annulus calcification is increasingly prevalent in developed countries, presenting distinct pathophysiological differences from rheumatic mitral stenosis.
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