Mitral Valve Development and Disease

Mitral valve disease, the focus of this Special Issue, is one of the most common forms of cardiac valve disease and affects ~2%–3% of the human population. As such, mitral valve defects carry a significant burden of morbidity and mortality and can lead to secondary complications such as arrhythmias, heart failure, and sudden cardiac death. Mitral valve surgery is currently the only therapeutic option for these patients, and is the fastest-growing cardiovascular intervention in the Western world. There are no effective nonsurgical treatments for this group of diseases, and therapeutic efforts have been hindered by an incomplete understanding of their fundamental causes. In recent years, our understanding of the genetic and molecular basis of heart valve diseases has significantly improved. New genetic discoveries have informed true causes of mitral valve disease in the human population. For the most part, cell lineages that contribute to the development of the mitral valve leaflets have been uncovered. However, the way in which these different cell lineages integrate to establish stratified valve tissues is less well understood. More importantly, research on how cellular, molecular, genetic, and epigenetic interactions interface with biomechanical cues to drive normal valve development remains in its infancy. Uncovering how defects in these various intrinsic and extrinsic factors can lead to valvular heart diseases is critical in understanding the pathophysiology of disease. Part and parcel with understanding the etiology of mitral valve disease is an appreciation of whether this understanding can impact clinical management and eventually lead to the development of new medical treatments. New research has suggested that a prolapsing mitral valve can have profound effects on extra-valvular cardiac tissues such as the annulus and left ventricular wall. Establishing mechanisms underlying secondary defects related to mitral valve disease may help inform new clinical management for this disease, with the opportunity of modifying current surgical and imaging guidelines. Similarly, how valve adaptations occur either in the context of new surgical approaches or in other cardiac conditions such as hypertrophic obstructive cardiomyopathies, endocarditis, and rheumatic and ischemic mitral regurgitation will fit logically within the framework of this Special Issue. A goal of this Issue is to stimulate new investigations into primary and secondary mitral valve defects and their relationship to pathological and clinical implications. We invite you to consider contributing a research paper or review article on any aspect related to the topic of this Special Issue. This may be also an opportunity for surgeons, cardiologists, cardiac imagers, clinical fellows, and doctoral and post-doctoral trainees to contribute to a review article and showcase their area of expertise.

Dr. Nina Ajmone Marsan
Dr. Russell Norris
Guest Editors

Manuscript Submission Information

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