Prognostic significance of mitral regurgitation after myocardial infarction: An echocardiography-based study

• Main Author: Vijaykumar V Ingle
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Medical Journal of Dr. D.Y. Patil University
• Subjects: Acute myocardial infarction; echocardiogram; mitral regurgitation; mortality
• Online Access: http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2016;volume=9;issue=5;spage=609;epage=612;aulast=Ingle

Background: Mitral regurgitation (MR) after acute myocardial infarction is common and often silent. Therefore, it should be specifically sought with careful physical examination and Doppler echocardiography. It also denotes an adverse prognosis. Materials and Methods: In this prospective study, we studied 52 patients of ST elevation acute myocardial infarction. The patients of ST elevation acute myocardial infarction whose admission electrocardiogram showed ST elevation of more than 0.1 mv (1 mm) in two or more limb leads or more than 0.2 mv (2 mm) in two or more chest leads were included in the study. Detailed echocardiographic analysis was done in all patients within 48 h of admission. MR jet was systematically evaluated using color Doppler as a primary tool. MR was classified as mild or moderate to severe depending on the recorded values. Results: Ischemic MR was detected in 22 patients. There were 12 patients with mild MR and 10 with moderate-to-severe MR. Thus, we had two groups of patients. One who had echocardiographically detected MR and other group without echocardiographically detected MR. Percentage of smokers was higher in the group of patients with MR than those without MR (72% and 60%, respectively). In addition, patients in the group with MR were with higher body mass index and were likely to present with higher Killip class on admission. Percentage of patients presenting with left ventricular (LV) enlargement was higher in the group of patients presenting with MR than those without MR (60% and 20%, respectively). In addition, LV dysfunction (both systolic as well as diastolic) was more prevalent in the group of patients presenting with MR than those without MR. Mortality percentage was higher in the group of patients presenting with MR than those without MR (22% and 10%, respectively). However, this difference was not statistically significant (P = 0.2597). Conclusion: Clinical or echocardiographic detection of MR derives its prognostic significance from an integration of multiple clinical, radiographic, electrocardiographic, and other echocardiographic characteristics.