Does left atrial enlargement contribute to mitral leaflet tethering in patients with functional mitral regurgitation? Proposed role of atriogenic leaflet tethering.

Papillary muscle repositioning due to left ventricular remodeling is thought to be the primary mechanism responsible for functional mitral regurgitation. This article proposes that remodeling (enlargement) of the left atrium also plays a role in the pathogenesis of functional mitral regurgitation, through a novel mechanism-atriogenic leaflet tethering-described herein.