Differences in right ventricular mechanics in acute and chronic ischemic mitral regurgitation after inferoposterior myocardial infarction

Abstract

Introduction: Functional mitral regurgitation (MR) developed after inferoposterior myocardial infarction (MI) may result in pulmonary hypertension and potentially leading to RV impairment. Purpose: We aimed to compare RV deformation at the acute and chronic MR phase in patients with inferoposterior MI. Methods: 45 patients with no or mild MR (controls) and 33 patients with grade =2 ischemic MR (IMR group) underwent 2D echocardiography during index admission for the first acute inferoposterior MI and at 3 months follow-up. Offline 2D speckle-tracking imaging (STE) analysis was performed with GE EchoPAC software. ?2 test was used for the descriptive, and Mann-Whitney/Student’s t test for the STE data with a significance level of <0.05. Results: Mean age, LV ejection fraction, and basal RV diameter did not differ between groups. Tricuspid annular plane systolic excursion was higher in IMR group than in controls at the acute MR, but no longer differed in remote phase of MR. RV global and septal longitudinal strains were similar in both groups. RV free-wall and basal deformation were significantly greater in the IMR group at the acute phase of MR, but only RV free-wall deformation remained higher in the IMR group at the chronic phase of MR (Table1). Conclusions: Ischemic MR in inferoposterior MI is associated with higher RV free-wall and basal deformation parameters at acute phase of MR, and greater RV free-wall deformation at the chronic phase of MR. [...].