Advances in the Management of Valvular Heart Disease

In recent decades, there has been considerable progress in the diagnosis and management of valvular heart disease. Use of echocardiography has been a major advance in understanding the pathophysiological aspects of common valvular diseases. In this issue of the Journal, Lacerda and Orton described a model to investigate the effects of chronic tensile stress on the mitral valve with inferences to those with myxomatous degeneration. Here, the important points are that chronic tensile loading puts undo mechanical forces on vulnerable parts of the valve and clearly contributes to progressive degenerative changes resulting in regurgitation. This model also adds on the evidences of robust relationship between mechanical load, pathologic mechanosensing pathway and structural change occurring at cellular level of valve [1-4]. Promising intervention to stop such vicious cycle at particular point is expectable to prevent or slow progression of disease.