CLINICAL-SIGNIFICANCE OF MITRAL REGURGITATION AFTER ACUTE MYOCARDIAL-INFARCTION

Citation
Ga. Lamas et al., CLINICAL-SIGNIFICANCE OF MITRAL REGURGITATION AFTER ACUTE MYOCARDIAL-INFARCTION, Circulation, 96(3), 1997, pp. 827-833
Citations number
31
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Peripheal Vascular Diseas",Hematology
Journal title
ISSN journal
0009-7322
Volume
96
Issue
3
Year of publication
1997
Pages
827 - 833
Database
ISI
SICI code
0009-7322(1997)96:3<827:COMRAA>2.0.ZU;2-Y
Abstract
Background Mitral regurgitation (MR) may complicate acute myocardial i nfarction (MI). However, it is not known whether mild MR is an indepen dent predictor of post-MI outcome. Methods and Results The study cohor t consisted of 727 Survival and Ventricular Enlargement Study patients who underwent cardiac catheterization, including left ventriculograph y, up to 16 days after MI. Left ventriculograms were analyzed for dias tolic and systolic volumes, global left ventricular sphericity, extent of wall motion abnormality, and endocardial curvature. The presence o f MR was related to the risk of developing a cardiovascular event duri ng 3.5 years of follow-up. MR was present in 141 patients (19.4%). Sev ere (3+) MR was present in only 2 patients. Patients with MR were more likely to have a persistently occluded infarct artery (MR versus no M R, 27.3% versus 15.2%; P=.001). Although the ejection fractions were s imilar, MR patients had larger end-systolic and end-diastolic volumes and more spherical ventricles than patients without MR. Sphericity cha nge from diastole to systole was also significantly reduced in MR pati ents. Patients with MR were more likely to experience cardiovascular m ortality (29% versus 12%; P<.001), severe heart failure (24% versus 16 %; P=.0153), and the combined end point of cardiovascular mortality, s evere heart failure, or recurrent myocardial infarction (47% Versus 29 %; P<.001). The presence of MR was an independent predictor of cardiov ascular mortality (relative risk, 2.00; 95% CI, 1.28 to 3.04). Conclus ions Mild MR is an independent predictor of post-MI mortality. As such , it adds important information for risk stratification of post-MI pat ients.