ArticleInteractive cardiovascular and thoracic surgery2021
Evolution from mitral annular dysfunction to severe mitral regurgitation in Barlow's disease.
Article in Interactive cardiovascular and thoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Mitral annular disjunction and high-risk profiles: a conceptual approach to risk stratification and surgical implications.General thoracic and cardiovascular surgery · 2026Pooled it
- Lessons learned during my 25 years as Dr. Carpentier's echocardiographer.Annals of cardiothoracic surgery · 2026Review
- The Arrhythmogenic Spectrum of Mitral Valve Disease: Pathophysiology, Risk Stratification, and Surgical Management.Journal of clinical medicine · 2026Review
- Mitral Annular Disjunction: A Roadmap for the Surgeon.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026Review
- Mechanisms of mitral valve development and disease.Frontiers in cardiovascular medicine · 2026Review
- Mitral Valve Surgery with and Without Mitral Annular Disjunction: A Meta-Analysis.Journal of cardiovascular development and disease · 2025Review
- Mitral annular disjunction and mitral valve prolapse: long-term risk of ventricular arrhythmias after surgery.European heart journal · 2025Article
- Mitral valve repair in severe mitral regurgitation due to Barlow's disease with concomitant mitral annular disjunction: a case report.General thoracic and cardiovascular surgery cases · 2025Article
- The Prevalence, Pathophysiological Role and Determinants of Mitral Annular Disjunction Among Patients with Mitral Valve Prolapse: A Systematic Review.Journal of clinical medicine · 2025Review
- Early Results of Minimally Invasive Mitral Valve Repair with Non-Resection Techniques in the Treatment of Barlow Disease.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2025Article
- Characterisation of global and regional mitral annular strains in an acute porcine model.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Recurrent mitral regurgitation after repair of Barlow's disease in a single-center retrospective cohort study.Quantitative imaging in medicine and surgery · 2024Article
- EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022Article
- Echocardiographic description and outcomes in a heterogeneous cohort of patients undergoing mitral valve surgery with and without mitral annular disjunction: a health service evaluation.Echo research and practice · 2022Article
- Mitral Valve Repair for Barlow's Disease with Mitral Annular and Subvalvular Calcification: A Case Report.Journal of chest surgery · 2022Article
- Surgical mitral valve repair technique considerations based on the available evidence.Turk gogus kalp damar cerrahisi dergisi · 2022Review
- Commentary: The Barlow valve: Understanding disease and symmetry.JTCVS techniques · 2021Article
- Arrhythmic Mitral Valve Prolapse: Introducing an Era of Multimodality Imaging-Based Diagnosis and Risk Stratification.Diagnostics (Basel, Switzerland) · 2021Review
- Characterization of Degenerative Mitral Valve Disease: Differences between Fibroelastic Deficiency and Barlow's Disease.Journal of cardiovascular development and disease · 2021Review
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesBarlow's disease (BD) is characterized by thick, redundant mitral valve (MV) leaflets, which can lead to prolapse and significant mitral regurgitation (MR). MV annular abnormalities are also commonly observed and increasingly recognized as possible primary pathology, with leaflet thickening being secondary to increased stress on the MV apparatus. To provide more insights into this hypothesis, the evolution of MV abnormalities over time in patients with BD was assessed.
methodsA total of 64 patients (54 ± 12 years, 72% male) with BD who underwent MV surgery and had multiple transthoracic echocardiograms (TTE) before surgery were included. In total, 186 TTE were analysed (median time interval 4.2, interquartile range 2.2-6.5 years) including specific MV characteristics.
resultsAt baseline, MV leaflet length, thickness, billowing height and annular diameter were larger in patients with BD compared to 59 healthy subjects. Systolic outward motion (curling) of the annulus was observed in 77% and severe mitral annular disjunction (≥5 mm) in 38% of patients with BD. Forty (63%) patients had MR grade I-II and 24 (37%) MR grade III-IV; at baseline, the 2 groups only differed in left atrial volume and in thickness and billowing height of the posterior leaflet, showing comparable MV annular abnormalities and dilatation despite different grades of MR. Over time, MV annulus diameter, leaflet length and billowing height increased significantly along with MR grade.
conclusionsIn patients with BD, MV annulus abnormalities are present at an early stage and precede the development of significant MR, suggesting their substantial role in the pathophysiology of this disease and as an important target for surgical treatment.
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