FEATURES OF OCCURRENCE ISCHEMIC MITRAL REGURGITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

A study was conducted, the purpose of which was to evaluate the prevalence and severity of MR immediately following ST-elevation (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) in contemporary clinical practice.
The research methods were clinical and anamnestic examination, objective examination, electrocardiography, laboratory diagnosticі, echocardiography and coronary angiography.
It was found that the predictors of the development of mitral regurgitation against the background of acute myocardial infarction are male gender (66%), the age of patients older than 67 years, multivessel damage according to coronary angiography (56%), time to revascularization is more than 31 hours, the ejection fraction of the left ventricle less than 40%. Factors associated with ≥ moderate MR were age (66 ± 12), male gender (10 of 16 [62,5%], low LVEF (39,94 ± 7,02); long time-to-revascularization (31 ± 4,7 h); and dilatation of the LV (LVEDVi: 74 ± 13 ml/m2 ), and left atrium (LAVi: 52 ± 14,8 ml/m2 ).
Mitral regurgitation after myocardial infarction is the result of multifactorial processes involving local and global left ventricular remodeling. Consistent evidence underscores its adverse impact on outcomes, independently of previously known indicators of risk after myocardial infarction. As mitral regurgitation is often clinically silent, it should be systematically evaluated by echocardiography. The evaluation should include precise quantification of the degree of mitral regurgitation to best appraise the ensuing risk.