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Pathogenesis of ischemic mitral insufficiency

M R Llaneras1, M L Nance, J T Streicher

  • 1Harrison Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104.

The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1993
PubMed
Summary
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A new sheep model reveals that neither papillary muscle infarction nor left ventricular dilation alone causes mitral regurgitation after moderate inferior myocardial infarction. The combination of both is required for significant mitral regurgitation to develop.

Area of Science:

  • Cardiovascular Research
  • Animal Models
  • Myocardial Infarction

Background:

  • Ischemic mitral regurgitation is a complication of myocardial infarction.
  • The specific mechanisms leading to mitral regurgitation after inferior myocardial infarction are not fully understood.

Purpose of the Study:

  • To develop and utilize a novel ovine model to investigate the pathophysiology of ischemic mitral insufficiency.
  • To test the hypothesis that combined posterior papillary muscle infarction and left ventricular dilatation are necessary for mitral regurgitation following moderate inferior myocardial infarction.

Main Methods:

  • A new animal model of ischemic mitral insufficiency was established in sheep.
  • Ligation of circumflex marginal coronary arteries was performed to induce myocardial infarction.

Related Experiment Videos

  • Left ventricular dimensions and mitral regurgitation were assessed over 8 weeks.

    • Main Results:

    • Infarction of 23% of left ventricular mass without papillary muscle involvement did not induce mitral regurgitation.
    • Infarction including the posterior papillary muscle (21% of left ventricular mass) led to progressive, severe mitral regurgitation.
    • Left ventricular dilatation occurred in both groups, but was associated with mitral regurgitation only when the papillary muscle was infarcted.

    Conclusions:

    • Neither posterior papillary muscle infarction nor left ventricular dilatation alone is sufficient to cause ischemic mitral regurgitation after moderate inferior myocardial infarction.
    • The combination of posterior papillary muscle infarction and left ventricular dilatation is required to produce significant mitral regurgitation in this model.