Maki Nogi1, Hiroyuki Okura2, Toru Kataoka3, Kiyoshi Yoshida4. 1. Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan. 2. Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan. hokura@fides.dti.ne.jp. 3. Division of Cardiology, Bell Land General Hospital, Sakai, Japan. 4. Division of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.
Abstract
BACKGROUND: Secondary or functional mitral regurgitation (FMR) has been reported associated with poor prognosis in patients with ischemic or non-ischemic cardiomyopathy. Prognostic impact of the FMR in myocardial infarction with preserved ejection fraction (MIpEF) is unknown. The aim of this study was to investigate predictors and prognostic impact of FMR in MIpEF. METHODS: A total of 556 patients with MIpEF were selected from the Bell Land General Hospital MI (BELAMI) registry (n = 953). Patients were grouped according to the presence or absence of severe FMR. Clinical endpoint was all-cause death. RESULTS: Severe FMR was present in 26 patients (4.7%) (FMR group) and absent in 530 patients (control). FMR group was older (77.5 ± 7.2 vs. 67.3 ± 11.3 years, P < 0.01) and had more female gender (54% vs. 28%, P < 0.01). By echocardiography, FMR group had larger left atrial diameter and left ventricular end-systolic volume. E and E/e' were significantly higher and deceleration time of E was significantly shorter in FMR group. By Kaplan-Meier analysis, survival was significantly lower in FMR group than in control (log-rank, P = 0.004). CONCLUSION: Severe FMR is rare in MI patients with preserved EF but is associated with poor long-term prognosis.
BACKGROUND: Secondary or functional mitral regurgitation (FMR) has been reported associated with poor prognosis in patients with ischemic or non-ischemiccardiomyopathy. Prognostic impact of the FMR in myocardial infarction with preserved ejection fraction (MIpEF) is unknown. The aim of this study was to investigate predictors and prognostic impact of FMR in MIpEF. METHODS: A total of 556 patients with MIpEF were selected from the Bell Land General Hospital MI (BELAMI) registry (n = 953). Patients were grouped according to the presence or absence of severe FMR. Clinical endpoint was all-cause death. RESULTS: Severe FMR was present in 26 patients (4.7%) (FMR group) and absent in 530 patients (control). FMR group was older (77.5 ± 7.2 vs. 67.3 ± 11.3 years, P < 0.01) and had more female gender (54% vs. 28%, P < 0.01). By echocardiography, FMR group had larger left atrial diameter and left ventricular end-systolic volume. E and E/e' were significantly higher and deceleration time of E was significantly shorter in FMR group. By Kaplan-Meier analysis, survival was significantly lower in FMR group than in control (log-rank, P = 0.004). CONCLUSION: Severe FMR is rare in MI patients with preserved EF but is associated with poor long-term prognosis.
Entities:
Keywords:
Mitral regurgitation; Myocardial infarction; Prognosis; Systolic function
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