Frequency of Ischemic Mitral Regurgitation after First- Time Acute Myocardial Infarction and its Relation to Infarct Location and In-Hospital Mortality

Abstract

Background: Ischemic mitral regurgitation (IMR) is a common complication after acute myocardial infarction (AMI). We aimed to investigate the frequency of IMR following first-time AMI and its association with infarct location, in-hospital mortality, and complications.
Methods: From September 2011 to November 2012, all patients with a diagnosis of first-time acute ST-elevation MI were enrolled in the study. Patients with previous MI and heart failure, organic mitral valve disorders, and previous mitral surgery were excluded from the study. The patients' baseline characteristic, echocardiographic parameters, and complications were recorded. The frequency of IMR after AMI and its relation to infarct location and in-hospital mortality were evaluated.
Results: Altogether, 250 patients (180 male) at a mean age of 60.21 ± 12.90 years were studied. IMR was detected in 114 (45%) patients. There was no association between the presence of MR and gender, systemic hypertension, smoking, diabetes mellitus, or body mass index; however, serum LDL-cholesterol and triglyceride levels were significantly higher in the patients with IMR. The most frequent territory of MI was anterior in the patients without MR, while the anterolateral territory was the most common one in the patients with IMR. The patients with IMR had more reduced left ventricular ejection fraction, more elevated left ventricular end-diastolic pressure, and higher pulmonary arterial pressure (p values < 0.001, < 0.001, and < 0.001, respectively). Stage III diastolic dysfunction was more frequent in the patients with IMR. All the deaths occurred in the IMR patients, who also had more complicated AMI.
Conclusion: IMR following AMI is highly prevalent, and it complicates about half of the patients. Regarding its relation to the AMI complications, assessment of the MR severity is necessary to make an appropriate decision for treatment.