P749 Echocardiographic risk factors of functional ischemic mitral regurgitation in patients with first acute myocardial infarction

Abstract

Abstract Purpose The aim of this study was to assess the correlation between the size of acute functional ischemic mitral regurgitation (FIMR) and selected left ventricle echocardiography measurements in patients (pts) with first ST-segment elevation myocardial infarction (STEMI) treated with effective primary angioplasty (PCI). Methods We analyzed 1578 consecutive hospitalized pts with STEMI (M-914; 66,4 ± 10,2 years) treated with PCI. The echocardiographic examination was performed at up to 3 days after admission. We assessed the frequency and size of FIMR, left ventricular end diastolic diameter (LVEDd), ejection fraction (EF), wall motion score index (WMSI) and systolic sphericity index (Sls). Effective regurgitation orifice area (EROA) was used for quantitative FIMR assessment (mild: <10 mm², moderate: ≥10 and < 20 mm², severe: ≥ 20mm²). The study population was divided into four groups depending on the size of FIMR. Correlation coefficient was used to determine correlations between data sets. Results We observed mild FIMR in 550 pts (34,9%) - group I, moderate in 356 pts (22,5%) - group II, severe in 57 pts (3,6%) - group III, no FIMR in 615 pts (39%) – group IV. Mean values of selected echocardiographic parameters in each analyzed group are shown in table 1. The positive good correlations between SIs and size of FIMR were found (r = 0,68) as well as weak correlations between LVEDd, WMSI and FIMR (ro = 0,25, ro = 0,34, respectively). The negative weak correlation between EF and size of IMR was present (ro = - 0,34). Conclusions 1. FIMR is a common complication in pts with STEMI treated with PCI. 2. We found a statistically significant correlation between SIs and FIMR severity. Table 1 Group I Group II Group III Group IV p LVEDd (cm) 5,22 ± 0,64 5,42 ± 0,56 5,72 ± 0,64 4,98 ± 0,58 NS EF (%) 48 ± 6 42 ± 8 35 ± 8 51 ± 8 NS WMSI 1,34 ± 0,28 1,42 ± 0,24 1,68 ± 0,32 1,32 ± 0,22 NS SIs 0,22 ± 0,1 0,32 ± 0,1 0,68 ± 0,1 0,18 ± 0,1 0,01 NS - non-significant