Abstract
It has been long believed that ischemic mitral regurgitation is
secondary to left ventricular remodelling and the mitral per se remains
unaffected. This proviso has recently been challenged and the mitral
valve has been described as a structure that responds and adapts to
challenges and attempts to correct the mitral regurgitation. The
response of mitral valves in this setting can be incomplete or can even
be mal-adapted. The ability of the mitral valve to respond in this
manner has been described as “mitral plasticity”. Endothelial to
Mesenchymal transition and Valvular Interstitial Cells are key to this
mitral plasticity and function through a complex array of signalling
pathways. Identification and manipulation of these pathways may provide
a possibility to correct the incomplete or mal-adapted mitral valve
responses. Surgical treatment can also be tailored based on whether the
valve has maladapted or has undergone incomplete adaptation.