Related Experiment Video

Updated: Aug 6, 2026

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
07:42

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

Published on: May 19, 2020

Dynamic Changes and Prognostic Impact of Ischemic Mitral Regurgitation in Recurrent Myocardial Infarction

Chiharu Nishino1,2, Shun Nishino1, Akihiro Hayashida3

  • 1Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center.

Circulation Journal : Official Journal of the Japanese Circulation Society
|July 22, 2026
PubMed
Abstract

Insights

Ischemic mitral regurgitation (IMR) worsens during recurrent myocardial infarction (MI) and often persists. Persistent IMR and reduced left ventricular ejection fraction (LVEF) predict poor long-term outcomes after MI.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Interventional Cardiology

Background:

  • Prognostic impact of ischemic mitral regurgitation (IMR) in recurrent myocardial infarction (MI) is not well understood.
  • Dynamic changes in IMR during recurrent MI require further investigation.
  • Assessing IMR in the context of recurrent MI is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate dynamic changes in IMR during recurrent MI.
  • To determine the prognostic implications of IMR in patients experiencing a second MI.
  • To identify predictors of persistent IMR and long-term adverse events.

Main Methods:

  • Retrospective review of 4,091 patients undergoing primary percutaneous coronary intervention for acute MI.
  • Analysis of 88 patients with recurrent MI, with echocardiography at three time points.
  • Assessment of IMR severity using mean vena contracta width; logistic and Cox regression analyses for predictors and outcomes.

Main Results:

  • IMR severity worsened at the onset of recurrent MI and remained elevated at discharge.
  • Older age, lower left ventricular ejection fraction (LVEF), and greater IMR severity at onset predicted persistent IMR.
  • Residual IMR and reduced LVEF were independently associated with a higher risk of 5-year adverse events (death, heart failure hospitalization, third MI).

Conclusions:

  • IMR exhibits dynamic changes during recurrent MI and frequently persists despite treatment.
  • Residual IMR and reduced LVEF are significant predictors of long-term adverse outcomes.
  • Assessment of residual IMR is vital for risk stratification in patients with recurrent MI.
Keywords:
Acute myocardial infarctionEchocardiographyIschemic mitral regurgitationPrognosisRecurrent myocardial infarction

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