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[Effect of Myocardial Reperfusion on Ischemic Mitral Regurgitation in Patients with Acute Myocardial Infarction]

I S Komarova1, L B Karova1, N V Andreeva1

  • 1Sechenov First Moscow State Medical University (Sechenov University).

Kardiologiia
|May 28, 2019
PubMed
Abstract

Insights

Reperfusion after acute myocardial infarction (AMI) causes varied changes in ischemic mitral regurgitation (IMR). While some patients show decreased IMR, many experience an increase, with no significant changes in systolic function or left ventricular contractility.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Interventional Cardiology

Background:

  • Reperfusion myocardial damage occurs after restoring blood flow in ischemic areas.
  • Ischemic mitral regurgitation (IMR) affects 11-19% of patients undergoing percutaneous coronary intervention (PCI) for coronary heart disease (CHD).
  • The impact of myocardial reperfusion on IMR in acute myocardial infarction (AMI) patients remains unclear.

Purpose of the Study:

  • To investigate the changes in quantitative indicators of ischemic mitral regurgitation (IMR) in patients with acute myocardial infarction (AMI) following myocardial reperfusion.

Main Methods:

  • Sixty-eight patients with AMI and IMR (aged 36-79) were studied.
  • Doppler echocardiography was performed before and 7 days after PCI to assess IMR parameters and left ventricular (LV) local contractility index (ILC).

Main Results:

  • Three patient groups emerged: decreased IMR (33.8%), increased IMR (41.1%), and unchanged IMR (25.1%).
  • Patients with increased IMR showed significant increases in LV end-diastolic volume, end-systolic volume, and left atrial volume.
  • No significant changes in LV systolic function or ILC were observed across groups, with no correlation between IMR severity and ILC.

Conclusions:

  • Myocardial reperfusion in AMI patients leads to diverse IMR dynamics without endogenous or drug protection.
  • A significant portion of patients experienced increased IMR post-reperfusion.
  • Systolic function and LV ILC remained stable, indicating IMR changes are not directly linked to overall contractility in this cohort.

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