Assessment of left ventricular long axis contraction in patients with ischemic mitral regurgitation after acute myocardial infarction

The development of ischemic mitral regurgitation (MR) after myocardial infarction (MI) may impose hemodynamic load during a period of active left ventricular remodeling and promote heart failure (HF). The aim of our study was to evaluate left ventricular (LV) long axis contraction assessed by both mitral annular plane systolic excursion (MAPSE) and peak systolic velocity in patients with ischemic MR after acute MI.MethodsThirty eight patients with a first attack of acute MI were classified into two groups. Group I comprised 18 patients with MI and ischemic MR, and group II comprised 20 patients with MI without ischemic MR. Twenty subjects without acute MI were considered as the control group (group III). Measurement of MAPSE from M-mode tracing of the mitral annulus from apical 4- and 2-chamber, and Pulsed wave tissue Doppler imaging (TDI) of the 4 sides of the mitral annulus for assessment of peak systolic (Sa) and diastolic (Ea and Aa) velocities were done.ResultsSignificant decrease of MAPSE in 4 sides in patients with acute MI with MR compared to MI without MR and control group (P<0.05). Peak systolic velocity (Sa) in septal, anterior, inferior sides of mitral annulus was significantly decreased in MI patients compared with control group (P<0.05); and not in lateral side (P>0.05). Significant correlation between MAPSE on anterior side of mitral annulus and LV EF (P<0.001) in patients with ischemic MR after acute MI.Conclusionmitral annular displacement is a useful parameter for assessment of longitudinal LV function in patients with ischemic MR after MI