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3D echo insights into AFMR mechanisms are hypothesis-generating; prospective studies needed before clinical adoption.
Atrial functional mitral regurgitation (AFMR) has been recently recognized as a subcategory of functional mitral regurgitation characterized by severe left atrial (LA) dilation and normal left ventricular (LV) dimensions and function. AFMR typically occurs in patients with atrial fibrillation (AF) and/or heart failure with preserved ejection fraction.1 Mitral annular dilation caused by severe LA remodeling has been traditionally considered the key mechanism of AFMR.1 However, the use of 3-dimensional imaging techniques and the study of LA mechanics have shown that other factors such as insufficient leaflet remodeling, atriogenic leaflet tethering, impaired annular dynamics and altered atrial mechanics may contribute to AFMR pathogenesis.
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Meucci et al. (2021) studied this question.
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