The impact of mild ischemic mitral regurgitation in the occurrence of congestive heart failure

Abstract

Ischemic mitral regurgitation (IMR) is a common complication of myocardial infarction, leading to left ventricular (LV) dysfunction and remodeling. Its presence is associated with an increased risk for death and heart failure. The aim of this study was to evaluate the impact of a mild degree (effective regurgitant orifice area < 20 mm 2 ) of IMR on heart failure (HF). This is a retrospective, study including 210 patients who had been hospitalized in a cardiology intensive care unit for myocardial infarction from September 2018 to March 2020, 36 patients with mild IMR were compared to 40 patients without IMR (controls), measuring LV volumes, ejection-fraction, and the degree of mitral regurgitation and incidence of HF events. The main age was 59.3 ± 7.02 sex ratio: 2.86 (74.1% male, 25.9% female) 32.3% of patients had de novo heart failure of which 29.2% with mild IMR. Patients with IMR had a significantly higher incidence of HF than controls (72% vs. 34%, P = 0.001), a significant increase in LV end-diastolic and end-systolic volumes, ( P = 0.004) and lower ejection-fractions ( P = 0.0002). The culprit artery was left anterior descending artery in 54.4%. The presence of IMR, even mild in degree, has an impact on the progression of the post-infarction ventricular dysfunction and a higher rate of HF.