Ms. Feinberg et al., Prognostic significance of mild mitral regurgitation by color Doppler echocardiography in acute myocardial infarction, AM J CARD, 86(9), 2000, pp. 903-907
Citations number
24
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Mitral regurgitation (MR) complicating acute myocardial infarction (AMI) is
associated with increased mortality. The prognostic significance of only m
ild MR detected by echocardiography in patients with AMI is unknown. This s
tudy assessed the long-term risk associated with mild MR detected by color
Doppler echocardiography within the first 48 hours of admission in 417 cons
ecutive patients with AMI. No MR was detected in 271 patients (65%), mild M
R was seen in 121 patient; (29%), and moderate or severe MR was noted in 25
patients (6%). One-year mortality rates were 4.8%, 12.4%, and 24%, respect
ively (p <0.001). Multivariate analysis revealed that mild MR was independe
ntly associated with increased I-year mortality (p <0.05) after adjustment
for age, gender, previous myocardial infarction, diabetes mellitus, systemi
c hypertension, Killip grade greater than or equal to2 on admission, and le
ft ventricular ejection fraction less than or equal to 40%. The hazard rati
o for I-year mortality was 2.31 (95% confidence interval 1.03 to 5.20) for
mild MR and 2.85 (95% confidence interval 0.95 to 8.51) for moderate or sev
ere MR. Thus, mild MR detected by color Doppler echocardiography within the
first 2 days of admission in patients with AMI is a significant independen
t risk predictor for 1-year all-cause mortality. (C)2000 by Excerpta Medico
, Inc.