Reduced Left Ventricular Apical Rotation: A Novel Pathophysiological Correlate Underlining Acute Ischemic Mitral
Shachar Kadosh1, Nadav Balkin1, Shemy Carasso1
1Jesselson Integrated Heart Center, the Eisenberg R&D Authority, Shaare Zedek Medical Center and Faculty of Medicine, the Hebrew University of Jerusalem, Israel.
The American Journal of Medicine
|May 5, 2025
Summary
Reduced apical rotation is linked to functional mitral regurgitation after ST-elevation myocardial infarction. This finding suggests a new mechanism for this common heart condition.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Cardiac Mechanics
Background:
- Functional mitral regurgitation (FMR) is associated with poor outcomes but its causes are unclear.
- Understanding FMR pathophysiology is crucial for improving patient care after myocardial infarction.
Purpose of the Study:
- To investigate the association between reduced apical rotation and FMR in patients with first acute ST-elevation myocardial infarction (STEMI).
Main Methods:
- Retrospective analysis of echocardiographic images from 164 patients with first STEMI.
- Comparison of patients with significant FMR versus those with less FMR.
- Logistic regression to identify determinants of FMR.
Main Results:
- Reduced apical rotation was significantly associated with FMR (P < .001).
- Each degree decrease in apical rotation increased the probability of significant FMR by 2.14.
- FMR patients had reduced ejection fraction and enlarged left ventricular and atrial diameters.
Conclusions:
- A significant correlation between reduced apical rotation and acute post-STEMI FMR was identified.
- This suggests reduced apical rotation may be a novel pathophysiological mechanism for FMR.
Keywords:
Apical rotationEchocardiographyMechanismMitral regurgitationMyocardial infarctionMyocardial twistMore Related Videos
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