Papel de la ecocardiografía en la detección y el pronóstico de la regurgitación mitral isquémica

Translated title of the contribution: Role of echocardiography in the detection and prognosis of ischemic mitral regurgitation

David Messika-Zeitoun, Siu Fung Yiu, Francesco Grigioni, Maurice Enriquez-Sarano

Research output: Contribution to journalEditorial

7 Scopus citations

Abstract

Ischemic mitral regurgitation (IMR) is mitral regurgitation (MR) due to complications of coronary artery disease and not fortuitously associated with it. Acute MR secondary to ruptured papillary muscle after myocardial infarction is rare and often fatal. We focus on functional MR, much more common, which occurs without any intrinsic valve disease. It was often underrated because of low murmur intensity but with the use of echocardiography this complication is observed between 15%-20% after a myocardial infarction. Recent advances in noninvasive Doppler echocardiography allow accurate assessment of regurgitant volume and effective regurgitant orifice and thus provide the tools to reliably evaluate the prognosis and mechanisms of IMR. IMR presence is associated with excess mortality. The mortality risk is directly related to the degree of regurgitation and a regurgitant volume ≥ 30 ml or an effective regurgitant orifice ≥ 20 mm2 define a high-risk group. Presence and degree of the regurgitation are related to local left ventricular remodeling. The apical and posterior displacement of papillary muscles leads to excess valvular tenting which in turn, in association with loss of systolic annular contraction, determines the severity of the regurgitation. In current clinical practice, IMR is mainly corrected by ring annuloplasty. However, this technique does not correct local alterations of left ventricular remodeling and its benefits on long-term outcome remains to be demonstrated.

Translated title of the contributionRole of echocardiography in the detection and prognosis of ischemic mitral regurgitation
Original languageSpanish
Pages (from-to)529-534
Number of pages6
JournalRevista Espanola de Cardiologia
Volume56
Issue number6
DOIs
StatePublished - Jun 1 2003

Keywords

  • Mitral valve
  • Myocardial infarction
  • Papillary muscle
  • Prognosis
  • Regurgitation
  • Remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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