主动脉瓣反流合并功能性二尖瓣反流研究进展
Research Progress of Aortic Regurgitation Combined with Functional Mitral Regurgitation
摘要: 主动脉瓣反流(Aortic Regurgitation, AR)合并功能性二尖瓣反流(Functional Mitral Regurgitation, FMR)在主动脉瓣反流患者中较为常见。由于左心室血流动力学紊乱，严重的AR将引起心室扩大并最终导致FMR出现。TAVR术后，持续FMR的AR患者有较差的预后。本综述将系统梳理AR合并FMR的病理生理机制以及介入治疗策略的最新演变，以期为临床个体化治疗提供参考。
Abstract: Aortic Regurgitation (AR) combined with Functional Mitral Regurgitation (FMR) is common in patients with aortic regurgitation. Due to the hemodynamic disturbance of the left ventricle, severe AR will cause ventricular enlargement and eventually lead to FMR. After TAVR, AR patients with persistent FMR have a poor prognosis. This review will systematically review the pathophysiological mechanism of AR combined with FMR and the latest evolution of interventional treatment strategies, in order to provide reference for clinical individualized treatment.
文章引用：严文成. 主动脉瓣反流合并功能性二尖瓣反流研究进展[J]. 临床医学进展, 2026, 16(4): 2897-2902. https://doi.org/10.12677/acm.2026.1641546

参考文献

[1] Unger, P., Pibarot, P., Tribouilloy, C., Lancellotti, P., Maisano, F., Iung, B., et al. (2018) Multiple and Mixed Valvular Heart Diseases. Circulation: Cardiovascular Imaging, 11, e007862. [Google Scholar] [CrossRef] [PubMed]
[2] Pawar, S., Allen, C., Mori, M., Markel, J., Patel, K., Thornton, G., et al. (2026) Contemporary Diagnosis and Treatment of Aortic Regurgitation: A State-Of-The-Art Review. JACC, 87, 385-413. [Google Scholar] [CrossRef] 
[3] Yang, L., Enriquez-Sarano, M., Scott, C.G., Padang, R., Maalouf, J.F., Pellikka, P.A., et al. (2020) Concomitant Mitral Regurgitation in Patients with Chronic Aortic Regurgitation. Journal of the American College of Cardiology, 76, 233-246. [Google Scholar] [CrossRef] [PubMed]
[4] Cao, J., Zheng, X., Chen, M., Liu, X., Liu, J. and Zhang, G. (2023) Effectiveness and Feasibility of Transcatheter Aortic Valve Replacement in Treating Combined Aortic and Mitral Regurgitation: A Retrospective Observational Study. Journal of Thoracic Disease, 15, 2763-2768. [Google Scholar] [CrossRef] [PubMed]
[5] Sugiura, A., Weber, M., von Depka, A., Tabata, N., Shamekhi, J., Al-Kassou, B., et al. (2020) Outcomes of Myocardial Fibrosis in Patients Undergoing Transcatheter Aortic Valve Replacement. EuroIntervention, 15, 1417-1423. [Google Scholar] [CrossRef] [PubMed]
[6] Quentin, V., Mesnier, J., Delhomme, C., Sayah, N., Guedeney, P., Barthélémy, O., et al. (2023) Transcatheter Mitral Valve Replacement Using Transcatheter Aortic Valve or Dedicated Devices: Current Evidence and Future Prospects. Journal of Clinical Medicine, 12, Article 6712. [Google Scholar] [CrossRef] [PubMed]
[7] Xiao, Z., Zheng, G., Geng, T., Lu, Z., Wang, Z., Zheng, L., et al. (2025) A Composite Index for Predicting Improvement of Mitral Regurgitation in Patients with Multivalvular Heart Disease after Transcatheter Aortic Valve Replacement. Frontiers in Cardiovascular Medicine, 12, Article 1679115. [Google Scholar] [CrossRef] 
[8] Bisbal, F., Baranchuk, A., Braunwald, E., Bayés de Luna, A. and Bayés-Genís, A. (2020) Atrial Failure as a Clinical Entity. Journal of the American College of Cardiology, 75, 222-232. [Google Scholar] [CrossRef] [PubMed]
[9] Li, X., Hagar, A., Wei, X., Chen, F., Li, Y., Xiong, T., et al. (2021) The Relationship of Mitral Annulus Shape at CT to Mitral Regurgitation after Transcatheter Aortic Valve Replacement. Radiology, 301, 93-102. [Google Scholar] [CrossRef] [PubMed]
[10] Lee, S., Oh, J.K., Lee, S., Kang, D., Lee, S., Kim, H.J., et al. (2022) Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation. Journal of the American Society of Echocardiography, 35, 947-955.e7. [Google Scholar] [CrossRef] [PubMed]
[11] Myagmardorj, R., Fortuni, F., Galloo, X., Nabeta, T., Meucci, M.C., Butcher, S.C., et al. (2024) Changes in Global Longitudinal Strain after TAVI: Additional Prognostic Value over Cardiac Damage in Patients with Severe Aortic Stenosis. Journal of Clinical Medicine, 13, Article 3945. [Google Scholar] [CrossRef] [PubMed]
[12] Kasa, G., Teis, A., De Raffele, M., Cediel, G., Juncà, G., Lupón, J., et al. (2025) Prognostic Value of Left Atrioventricular Coupling Index in Heart Failure. European Heart Journal—Cardiovascular Imaging, 26, 610-617. [Google Scholar] [CrossRef] [PubMed]
[13] Fortuni, F., Biagioli, P., Myagmardorj, R., Mengoni, A., Chua, A.P., Zuchi, C., et al. (2024) Left Atrioventricular Coupling Index: A Novel Diastolic Parameter to Refine Prognosis in Heart Failure. Journal of the American Society of Echocardiography, 37, 1038-1046. [Google Scholar] [CrossRef] [PubMed]
[14] Zsarnoczay, E., Varga-Szemes, A., Schoepf, U.J., Rapaka, S., Pinos, D., Aquino, G.J., et al. (2025) Predicting Mortality after Transcatheter Aortic Valve Replacement Using AI-Based Fully Automated Left Atrioventricular Coupling Index. Journal of Cardiovascular Computed Tomography, 19, 201-207. [Google Scholar] [CrossRef] [PubMed]
[15] Lo Iudice, F., Ravera, A., Campanile, A., Romei, S. and Vigorito, F. (2025) Cardiogenic Shock in a Patient with Combined Severe Aortic and Mitral Regurgitation Treated by a Totally Percutaneous Approach: A Case Report. European Heart Journal—Case Reports, 9, ytaf185. [Google Scholar] [CrossRef] [PubMed]
[16] 马云龙, 李瑞锋, 何明俊, 等. 经导管主动脉瓣置换术联合经导管二尖瓣缘对缘修复术同期治疗主动脉瓣反流合并二尖瓣脱垂1例[J]. 中国介入心脏病学杂志, 2025, 33(10): 588-593.
[17] Praz, F., Borger, M.A., Lanz, J., Marin-Cuartas, M., Abreu, A., Adamo, M., et al. (2025) 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease. European Heart Journal, 46, 4635-4736. [Google Scholar] [CrossRef] 

为你推荐