Mitral regurgitation in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: prognostic significance and relation to ventricular size and function

Abstract

Following high-risk myocardial infarction, baseline mitral regurgitant severity is associated with larger LV volumes and worse LV function. Both baseline MR severity and progression of MR are associated with an increased likelihood of adverse outcomes.

Mechanical Dyssynchrony After Myocardial Infarction in Patients With Left Ventricular Dysfunction, Heart Failure, or Both

“…Mitral regurgitation after MI is usually secondary to alternations in myocardial structure and function rather than due to abnormalities of the mitral leaflets themselves, is known to be associated with worse outcomes after MI, and thus might contribute to the adverse effects of worsened ventricular synchrony. 12,36 Two-dimensional speckle tracking has enhanced the ability to assess regional and global myocardial properties noninvasively because of its angle independence, which overcomes the limitations of tissue Doppler imaging. 37,38 The specific method used in this analysis, velocity vector imaging, [15][16][17][18][19] has been recently validated with sonomicrometry.…”

“…Standard echocardiographic parameters, including ventricular volumes and ejection fractions, were analyzed with an offline analysis workstation as previously described. [11][12][13][14] Dyssynchrony indexes were measured with B-mode speckle tracking software (velocity vector imaging, Axius VVI 2.0, Siemens Medical Solutions, Malvern, Pa) that circumvents angle dependency and identifies cardiac motion by tracking multiple reference points, inward and outward border motion, motion of tissue along the direction of the border, and periodicity between cardiac cycles. [15][16][17][18][19] After tracing the subendocardium of the left ventricle, the semiautomated tracking algorithm outlined the myocardium from frame to frame throughout the cardiac cycle, and velocity vectors, overlaid onto the B-mode image, were displayed with the direction and relative speed of the tissue.…”

Influence of Torasemide on Electrical Instability of the Heart in Patients With Ischemic Mitral Regurgitation Post Myocardial Infarction

“…Результаты исследований последних лет показали, что у большинства пациентов с Q-ИМ течение забо-левания осложняется ИМР, которая часто приводит к развитию ХСН [6]. Медикаментозное лечение пациентов с ИМР, перенесших Q-ИМ, направлено на предупреждение дальнейшего прогрессирования клапанной дисфункции и ХСН, развития острой коронарной недостаточности и прогрессирования ИБС, ее осложнений нарушениями ритма и прово-димости сердца.…”

Effect of Mitral Regurgitation on Chronic Heart Failure Course and Structure-Functional Heart State

“…This leads to compensatory augmentation of heart rate. CHF patients with MR often have low cardiac output, enlarged LA [33,34] and LV volumes, with LV getting more spheral [34][35][36]. LV specific volume increases because of simultaneous evacuation in aorta (effective cardiac output) and in left atrium (regurgitation volume).…”

“…Это ве-дёт к компенсаторному увеличению частоты сердечных со-кращений. У больных ХСН с МР нередко снижен сердеч-ный выброс, увеличены объёмы левого предсердия [33,34] и ЛЖ, форма которого становится более сферичной [34][35][36]. В связи с одновременным опорожнением лево-го желудочка в аорту (эффективный сердечный выброс) и в левое предсердие (объём регургитации) его удельный объём увеличивается.…”