Mitral Valve Leaflet Remodeling After Myocardial Infarction

It is a matter of force. It is a balance of valve closing force and tethering force that affects mitral valve coaptation. Ischemic mitral regurgitation develops secondary to left ventricular dysfunction generally with structurally normal leaflets. However, it seems it is not simply a matter of force when we see the fact that valve leaflets histologically change after myocardial infarction. The leaflets can stretch, can grow in area, and can increase in thickness. Recent studies have shown evidence of leaflet remodeling and have proposed new insights from the biological reaction of the leaflet. Some specific biological markers are activated in the ischemic environment and cause histopathologic changes in the leaflet. Thus, it is not just about the force, and we cannot ignore the leaflet pathology and function when we consider the mechanism of ischemic mitral regurgitation. Mitral valve complex is becoming more complex.