Mechanism of higher incidence of ischemic mitral, regurgitation in patients with inferior myocardial infarction: Quantitative analysis of left ventricular and, mitral valve geometry in 103 patients with prior myocardial infarction
Mechanism of higher incidence of ischemic mitral, regurgitation in patients with inferior myocardial infarction: Quantitative analysis of left ventricular and, mitral valve geometry in 103 patients with prior myocardial infarction
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DOI：
10.1067/mtc.2003.78
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发表时间：
2003-01-01
影响因子：
6
通讯作者：
Tei, CW
中科院分区：
文献类型：
--
作者：
Kumanohoso, T;Otsuji, Y;Tei, CW
目的：下壁心肌梗死患者与前壁心肌梗死患者相比，尽管左室整体重构和功能障碍较少，但缺血性二尖瓣返流发生率较高的机制仍存在争议。我们假设下壁心肌梗死引起左心室重构，使后乳头肌远离其正常位置，导致缺血性二尖瓣返流：103例既往心肌梗死患者（前壁组61例，下壁组42例）和20例正常对照组，根据多普勒血流频谱面积百分比评价缺血性二尖瓣返流程度，左心室舒张末期和收缩末期容积、收缩中期二尖瓣环面积以及乳头肌尖端和对侧前二尖瓣环之间的收缩中期小叶栓系距离，通过定量超声心动图测定。52 +/- 18 vs 60 +/- 24 mL，下壁vs前壁梗死，P< .05;左心室射血分数：51% +/- 9% vs 42% +/-7%，P
Objective: The mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior compared, with anterior myocardial infarction despite less global left ventricular remodeling and dysfunction is controversial. We hypothesized that inferior myocardial infarction causes left ventricular remodeling, which displaces posterior papillary muscle away from its normal position, leading to ischemic mitral regurgitation:Methods: In 103 patients with prior myocardial infarction (61 anterior and 42 inferior) and 20 normal control subjects, we evaluated the grade of ischemic mitral regurgitation on the basis of the percentage of Doppler jet area, left ventricular end-diastolic and end-systolic volumes, midsystolic mitral annular area, and midsystolic leaflet-tethering distance between papillary muscle tips and the contralateral anterior mitral annulus, which were determined by means of quantitative echocardiography.Results: Global left ventricular dilatation and dysfunction were significantly less pronounced in patients with inferior myocardial infarction (left ventricular endsystolic volume: 52 +/- 18 vs 60 +/- 24 mL, inferior vs anterior infarction, P< .05; left ventricular ejection fraction: 51% +/- 9% vs 42% +/- 7%, P