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Mechanism of mitral regurgitation in the acute phase of inferior wall myocardial infarction: reduced closing force as a consequence of left ventricular systolic dysfunction in the presence of tethering as a determinant of mitral regurgitation

Authors
 Sung-Jin Hong  ;  Sung-Ai Kim  ;  Jong-Won Ha  ;  Namsik Chung  ;  Yangsoo Jang  ;  Donghoon Choi  ;  Eui-Young Choi  ;  Young-Guk Ko  ;  Jung-Sun Kim  ;  Chi Young Shim  ;  Sang-Jae Rhee  ;  Jin Hur 
Citation
 Circulation Journal, Vol.75(3) : 619-625, 2011 
Journal Title
 Circulation Journal 
ISSN
 1346-9843 
Issue Date
2011
Abstract
BACKGROUND: To delineate the mechanism of mitral regurgitation (MR) in the acute phase of inferior wall myocardial infarction (MI). METHODS AND RESULTS: In 97 patients (age 59 ± 12 years) with acute inferior wall MI, the severity of MR, left ventricular (LV) geometric changes and function within 1.7 ± 1.3 days after MI by echocardiography was retrospectively evaluated. Infarct size was measured within 3.9 ± 1.7 days by cardiac magnetic resonance. Mild MR was present in 16 (16.5%) and moderate MR in 12 (12.4%) of 97 patients. There were no significant differences in mitral annular area, sphericity and distances between papillary muscle tips and the contralateral mitral annulus. However, patients with moderate MR had significantly larger LV end-systolic volume, tenting area and infarct size. There was a graded relationship between the severity of MR and LV ejection fraction. In a multivariable regression analysis, LV ejection fraction and tenting area were found to be independent predictors of the severity of MR (r(2)=0.180, P=0.001). CONCLUSIONS: MR was associated with LV systolic dysfunction, increase in end-systolic LV volume and tethering of mitral leaflet, suggesting reduced closing force as a consequence of LV systolic dysfunction in the presence of leaflet tethering would play a more pivotal role in the development of MR.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92728
DOI
10.1253/circj.CJ-10-0859
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk) ; 김성애(Kim, Sung Ai) ; 김중선(Kim, Jung Sun) ; 심지영(Shim, Chi Young) ; 이상재(Lee, Sang Jae) ; 장양수(Jang, Yang Soo) ; 정남식(Chung, Nam Sik) ; 최동훈(Choi, Dong Hoon) ; 최의영(Choi, Eui Young) ; 하종원(Ha, Jong Won) ; 허진(Hur, Jin) ; 홍성진(Hong, Sung Jin)
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