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Echocardiographic Determinants of Ischemic Mitral Regurgitation
Author(s) -
Nouri Masoumeh,
Tokaldany Masoumeh Lotfi,
Shahrzad Maryam,
Mardanloo Azam Safir,
Ahmadi Seyyed Hossein,
Roomi Zahra Savand,
Sadeghian Hakimeh
Publication year - 2013
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12145
Subject(s) - medicine , mitral regurgitation , cardiology , functional mitral regurgitation , mitral valve , heart failure , ejection fraction
Objectives It is not clear whether the presence and degree of chronic ischemic mitral regurgitation (IMR) in patients with left ventricular (LV) dysfunction are related to LV dysfunction, local LV remodeling or mitral valve deformation. We sought to establish the strongest determinants of IMR severity in patients with LV dysfunction and IMR. Methods We prospectively performed transthoracic echocardiography for 135 patients (mean age = 60.76 ± 9.69 years, 71.9% male) with LV dysfunction (ejection fraction ≤ 50%) and coronary artery disease (70% stenosis in ≥1 coronary artery and no myocardial infarction during the previous 16 days). Global and local LV remodeling and mitral deformity indices were measured. Using the vena contracta, MR severity was graded as no regurgitation; mild; moderate; and severe. Results Mild regurgitation was found in 45 (33.3%) patients, moderate in 71 (52.6%), severe in 6 (4.4%), and no regurgitation in 13 (9.6%). By linear logistic multivariable analysis, the major echocardiographic determinants of MR severity were tenting area (TA), sphericity index (LV systolic length/width), and C‐septal (distance between the leaflet coaptation and the septum). TA was best related to coaptation depth and annulus diameter. Mitral annular diameter was best correlated with left atrial surface area (r = 0.630, p < 0.001). Conclusion TA was significantly correlated with annulus diameter and, along with sphericity index and C‐septal, were the independent echocardiographic determinants of MR severity. These findings warrant consideration when performing mitral valve repairs for patients with IMR. doi: 10.1111/jocs.12145 (J Card Surg 2013;28:359–365)