biomedicines Review Ischemic Mitral Regurgitation: A Multifaceted Syndrome with Evolving Therapies Mattia Vinciguerra 1,* , Francesco Grigioni 2, Silvia Romiti 1 , Giovanni Benfari 3,4, David Rose 5 , Cristiano Spadaccio 5,6, Sara Cimino 1, Antonio De Bellis 7 and Ernesto Greco 1 1 Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy;
[email protected] (S.R.);
[email protected] (S.C.);
[email protected] (E.G.) 2 Unit of Cardiovascular Sciences, Department of Medicine Campus Bio-Medico, University of Rome, 00128 Rome, Italy;
[email protected] 3 Division of Cardiology, Department of Medicine, University of Verona, 37219 Verona, Italy;
[email protected] 4 Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA 5 Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool FY3 8NP, UK;
[email protected] (D.R.);
[email protected] (C.S.) 6 Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK 7 Department of Cardiology and Cardiac Surgery, Casa di Cura “S. Michele”, 81024 Maddaloni, Caserta, Italy;
[email protected] * Correspondence:
[email protected] Abstract: Dysfunction of the left ventricle (LV) with impaired contractility following chronic ischemia or acute myocardial infarction (AMI) is the main cause of ischemic mitral regurgitation (IMR), leading to moderate and moderate-to-severe mitral regurgitation (MR). The site of AMI exerts a specific Citation: Vinciguerra, M.; Grigioni, influence determining different patterns of adverse LV remodeling. In general, inferior-posterior F.; Romiti, S.; Benfari, G.; Rose, D.; AMI is more frequently associated with regional structural changes than the anterolateral one, which Spadaccio, C.; Cimino, S.; De Bellis, is associated with global adverse LV remodeling, ultimately leading to different phenotypes of IMR.