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

Abstract

Ischemic mitral regurgitation (MR)is a secondary mitral valve incompetence due to underlying myocardial dysfunction and left ventricular (LV) remodelling. Purpose: This study aimed to compare LV mechanics in acute and chronicMRin patients with inferoposterior MI. Methods: 2D echocardiography was performed in 34 patients with no or mild MR (NMR group) and 35 patients with grade ≥2 ischemic MR (IMR group) during index admission for first acute inferoposterior MI and at 3 months follow-up. Offline speckle tracking (STE) analysis was performed withGEEchoPACsoftware. Parametric and non-parametric tests were used: x2 test for the descriptive, and Mann-Whitney/Student’s t test for STE data. Results: Age and ejection fraction did not differ between the groups. Circumferential and radial strains were found to be worse in IMR group during index assessment in acute phase of MI. However, only circumferential strains remained significantly reduced in IMR group upon follow up. There were no significant differences between the groups in longitudinal and radial LV deformation parameters neither during the index assessment nor upon follow up (Table). Conclusions: Ischemic MR in acute inferoposterior MI is associated with impaired circumferential and radial myocardial deformation. In the meantime, its chronic form is mainly distinguished by predominant circumferential LV deformation impairment. Abstract P1311 Table. Myocardial deformation parameters Parameter NMR group IMR group P value Acute phase of MI Age 60.4+11.4 61.9+12.0 0.7 LVEF (%) 51.6+7.2 51.5+9.2 1.0 GLS (%) -17.9+2.5 -17.6+2.7 0.6 GCS (%) -17.6+7.9 -13.4+3.4 0.001 GRS (%) 37.12+12.13 28.10+12.88 0.003 Remote phase after MI GLS -18.54+2.65 -17.95+3.06 0.4 GCS -15.68+3.68 -13.76+3.23 0.03 GRS 31.15+11.52 27.70+12.35 0.2 NMR - no significant mitral regurgitation group; IMR - ischemic mitral regurgitation group; LVEF - left ventricular ejection fraction;G- global; L=longi