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Predictors and prognostic impact of secondary mitral regurgitation in myocardial infarction with preserved ejection fraction

  • Maki Nogi
  • Hiroyuki OkuraEmail author
  • Toru Kataoka
  • Kiyoshi Yoshida
Original Investigation
  • 28 Downloads

Abstract

Background

Secondary or functional mitral regurgitation (FMR) has been reported associated with poor prognosis in patients with ischemic or non-ischemic cardiomyopathy. Prognostic impact of the FMR in myocardial infarction with preserved ejection fraction (MIpEF) is unknown. The aim of this study was to investigate predictors and prognostic impact of FMR in MIpEF.

Methods

A total of 556 patients with MIpEF were selected from the Bell Land General Hospital MI (BELAMI) registry (n = 953). Patients were grouped according to the presence or absence of severe FMR. Clinical endpoint was all-cause death.

Results

Severe FMR was present in 26 patients (4.7%) (FMR group) and absent in 530 patients (control). FMR group was older (77.5 ± 7.2 vs. 67.3 ± 11.3 years, P < 0.01) and had more female gender (54% vs. 28%, P < 0.01). By echocardiography, FMR group had larger left atrial diameter and left ventricular end-systolic volume. E and E/e′ were significantly higher and deceleration time of E was significantly shorter in FMR group. By Kaplan–Meier analysis, survival was significantly lower in FMR group than in control (log-rank, P = 0.004).

Conclusion

Severe FMR is rare in MI patients with preserved EF but is associated with poor long-term prognosis.

Keywords

Mitral regurgitation Myocardial infarction Prognosis Systolic function 

Notes

Compliance with ethical standards

Conflict of interest

Maki Nogi, Hiroyuki Okura, Toru Kataoka and Kiyoshi Yoshida declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent for echocardiographic examination was obtained from all patients. As described in the methods section, informed consent for being included in this specific study was not obtained because the ethical committee of the institution (Bell Land General Hospital) did not require either approval by the committee or informed consent from the patients for this retrospective observational analysis.

Supplementary material

12574_2019_451_MOESM1_ESM.TIF
Supple Figure A Comparison of cardiac event-free survival between FMR treated with and without renin–angiotensin inhibitors. Cardiac event-free survival was similar between FMR treated with and without RASI FMR = functional mitral regurgitation, RASI = renin–angiotensin system inhibitors. (TIFF 36 kb)

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Copyright information

© Japanese Society of Echocardiography 2019

Authors and Affiliations

  • Maki Nogi
    • 1
  • Hiroyuki Okura
    • 2
    Email author
  • Toru Kataoka
    • 3
  • Kiyoshi Yoshida
    • 4
  1. 1.Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
  2. 2.Department of CardiologyGifu University Graduate School of MedicineGifuJapan
  3. 3.Division of CardiologyBell Land General HospitalSakaiJapan
  4. 4.Division of CardiologyThe Sakakibara Heart Institute of OkayamaOkayamaJapan

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