Prognostic significance of mild mitral regurgitation by color Doppler echocardiography in acute myocardial infarction

Feinberg, Micha S.; Schwammenthal, Ehud; Shlizerman, Lev; Porter, Avital; Hod, Hanoch; Freimark, Dov; George‐Levi, Sivan; Boyko, Valentina; Mandelzweig, Lori; Vered, Zvi; Behar, Solomon; Sagie, Alex

doi:10.1016/s0002-9149(00)01119-x

Cited by 135 publications

(84 citation statements)

References 22 publications

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“…Ischemic mitral regurgitation after MI is frequently observed and is usually mild [8,21,22]. In our study group, second-grade mitral regurgitation was found in 3 of 29 patients with ischemic mitral regurgitation compared to 10 % in the published data [8].…”

Section: Discussionmentioning

confidence: 41%

Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

Bretschneider

Heinrich

Seeger

et al. 2017

Fortschr Röntgenstr

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This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function.Methods and Materials 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included. The location and extent of MI depicted by MRI were correlated with left ventricular function assessed by MRI and mitral regurgitation assessed by echocardiography. The presence, location and extent of PM infarction depicted by late gadolinium enhancement (LGE-) MRI were correlated with functional parameters and compared with patients with chronic MI but no PM involvement.Results PM infarction was found in 11 of 48 patients (23 %) using LGE-MRI. 8/11 patients (73 %) with PM infarction and 22/37 patients (59 %) without PM involvement in MI had ischemic mitral regurgitation. There was no significant difference between location, extent of MI and presence of mitral regurgitation between patients with and without PM involvement in myocardial infarction. In 4/4 patients with complete and in 4/7 patients with partial PM infarction, mitral regurgitation was present. The normalized mean left ventricular enddiastolic volume was increased in patients with ischemic mitral regurgitation. ConclusionThe presence of PM infarction does not correlate with ischemic mitral regurgitation. In patients with complete PM infarction and consequent discontinuity of viable tissue in the PM-chorda-mitral valve complex, the probability of developing ischemic mitral regurgitation seems to be increased. However, the severity of mitral regurgitation is not increased compared to patients with partial or no PM infarction.

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Section: Discussionmentioning

confidence: 41%

Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

Bretschneider

Heinrich

Seeger

et al. 2017

Fortschr Röntgenstr

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“…Thus, prognostic factors in acute cardiogenic shock mirror those for less complicated MI. [17][18][19][20] The prognostic importance of LVEF may not appear surprising in light of the prior studies of post-MI patients. 18 -20 However, in most reports examining the significance of LVEF after MI, LVEF assessment occurred later during the healing process, and the mean LVEF was higher than in the present trial.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Predictors of Survival and Response to Early Revascularization in Cardiogenic Shock

et al. 2003

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for the SHOCK Trial Background-Although echocardiography is used in diagnosis and management of myocardial infarction, it has not been established whether specific features of cardiac structure or function early in the course of cardiogenic shock provide prognostic value. The purposes of this substudy of the SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK (SHOCK) trial were to describe the echocardiographic features of cardiogenic shock, identify findings on early echocardiograms associated with outcome, examine the interaction of such features with treatment, and determine whether these features could provide insights into the survival benefit observed with early revascularization and guide selection of patients for this strategy. Methods and Results-One hundred seventy-five echocardiograms performed within 24 hours of randomization to the early revascularization (ERV) or initial medical stabilization (IMS) arms of the trial were submitted for quantitative assessment, and 169 were suitable for analysis. The 2 groups were similar in terms of clinical and early echocardiographic characteristics. Mean left ventricular ejection fraction (LVEF) was 31%, and moderate or greater mitral regurgitation (MR) was noted in 39.1%. On multivariate analysis, the only independent predictors of survival were MR severity and LVEF. A survival benefit for the ERV strategy was observed at all levels of LVEF and MR. Conclusions-A wide range of cardiac structural and functional abnormalities exists in patients presenting with acute cardiogenic shock. Both short-and long-term mortality appear to be associated with initial left ventricular systolic function and MR as assessed by echocardiography, and a benefit of ERV is noted regardless of baseline LVEF or MR.

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“…Echocardiographic studies of ischemic mitral regurgitation also have confirmed the prognostic significance of even mild mitral regurgitation. 6,7 One-year mortality rates of 4.8%, 12.4%, and 24% were observed among 417 patients assessed within 48 hours of MI with absent, mild, and moderate to severe mitral regurgitation, respectively. Multivariate analysis revealed that even mild mitral regurgitation was independently associated with a significantly increased risk of death at 1 year (adjusted relative risk 2.31).…”

Section: See P 295 Ischemic Mitral Regurgitation and Prognosis After MImentioning

confidence: 99%

Ischemic Mitral Regurgitation and Its Related Risk After Myocardial Infarction

2005

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Prognostic significance of mild mitral regurgitation by color Doppler echocardiography in acute myocardial infarction

Cited by 135 publications

References 22 publications

Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

Echocardiographic Predictors of Survival and Response to Early Revascularization in Cardiogenic Shock

Ischemic Mitral Regurgitation and Its Related Risk After Myocardial Infarction

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