Incidence and in-hospital complications of acute mitral regurgitation in the early phase of acute myocardial infarction in Erbil teaching hospital

  • Firaz Muhammad Mawlood Department of Medicine, Hawler Teaching hospital,Erbil-iraq
  • Abdulkareem A. Al-Othman Department of Medicine, College of Medicine, Hawler Medical University, Erbil-Iraq
Keywords: Acute MI, MR

Abstract

Background and objectives: Acute mitral regurgitation is one of the mechanical complications of acute myocardial infarction. The aim of the study was to detect the incidence of ischemic mitral regurgitation and its effect on in-hospital complications in early phase of acute myocardial infarction.

Method: The study sample consisted of 100 patients with first attack of acute myocardial infarction admitted to Coronary Care Unit in Erbil Teaching Hospital from October 2009 to May 2010.The patients categorized into: group-I which represent those without mitral regurgitation; group-II represent those with mitral regurgitation and the latter categorized patients with mild mitral regurgitation (group-IIA) and those with moderate-severe mitral regurgitation (group-IIB).

Results: The incidence of acute mitral regurgitation among patients with acute myocardial infarction was 33%. Fourteen patient (42.42%) had mild and 19 (57.58%) had moderate-severe mitral regurgitation. Group-II patients were older (mean age: 65.4±10.76 years) than group-I (mean age 56±11), p value=0.01. Left ventricular systolic dysfunction among group-IIA, 9 patients (64.28%) and group-IIB, 16 patients (84.21%) were higher than group-I, 12 patients (17.91%), p=<0.001.

Conclusion: Acute mitral regurgitation is common in early phase of acute myocardial infarction and it is strongly associated with left ventricular systolic dysfunction.

References

Thomas H, Patrizio L, Luc P. Ischemic mitral regurgitation: mechanisms and Diagnosis. Heart 2009;95:1711-1718.

Eisenberg PR, Barzilai B, Perez JE, Non-invasive detection by Doppler echocardiography of combined ventricular septal rupture and mitral regurgitation in acute myocardial inarction. J Am Coll Cardiol.1984;4:617- 20.

De Servi S, Vaccari L, Assandri J. Clinical significance of mitral regurgitation in patients with recent myocardial infarction. Eur Heart J.1988;9:5-9.

Tcheng JE, Jackman JD Jr, Nelson CL, et al. Outcome of patient sustaining acute ischemic mitral regurgitation during myocardial infarction. AnnIntern Med.1992;117(1):18 –24.

Bolooki H. Emergency cardiac procedures in patients in cardiogeni shock due to complications of coronary artery disease. Circulation 1989; 79:I137– 48.—etiologies, management and outcome: a report from the SHOCK Trial Registry. J Am Coll Cardiol. 2000; 36:1063–70

Rosamond W, Flegal K, Friday G. Heart disease and Stroke statistics- 2007 update: a report from the American Heart Committee and Stroke Statistics Subcommittee.Circulation.2007; 115:69- 171.

Anderson JL. ST segment acute myocardial infarction and complications of myocardial infarction. In: Goldman Land Ausiello D, (eds). Cecil Textbook of Medicine. 23rd Edition. USA.SAUNDERS ELSEVIER.2007.p.508.

Elliot A, Jean-Pierre B, Werner O, Jose L, Lopez S, Lars R et al . Myocardial Infarction redefined. J Am Coll Cardiol.2000; 36:959-969.

Ramadas G, Pal and Pravin M. Shah. Assessment of left ventricular Function. In: Gerald M, Pohost A.O, Daniels B, Pravin M.,(eds)Imaging in Cardiovascular Diseases. First ed. Lippincott Williams and Willkins .2000;p. 23-41.

Enriquez- Saramo M, Schaff HV, Tajik AJ. Chronic mitral Regurgitation. In: Alpert JS, Dalen JE, Rahimtoala SH (eds): Valvular Heart Disease. 3rd ed. Philadelphia. Lippincott Williams and Wilkins.2000; p. 113-142.

Matsummura T, Ohtaki E, Tanaka K. Echocardiographic predictors of Left ventricular dysfunction after mitral valve repair for mitral regurgitation as an indicator to decide the optimal timing of repair. J Am Cardiol.2003; 42:458.

Feigenbaum H,Armstrong WF, Ryan T. Coronary Artery Disease. Feigenbaum's Echocardiography, 6th Edition,Lippincott Williams and Wilkins Company,2005.p.306-469.

Kono T, Sabbah HN, Rosman H, Alam M, Jafri S, Stein PD, Goldstein S. Mechanism of functional mitral regurgitation during acute myocardial Ischemia. J Am Coll Cardiol.1992;19:1101-1105.

Barzilai B, Davis VG, Stone PH, Jaffe AS. Prognostic significance of mitral regurgitation in acute myocardial infarction. Am J Cardiol.1990; 65:1169-1175.

Lamas GA, Mitchell GF, Flaker GC, Smith SC Jr, Gresh BJ, Basta L et al. Clinical significance of mitral regurgitation after acute myocardial infarction. Circulation 1997; 96:827-833.

Lehmann KG, Francis CK, Dodge HT. Mitral regurgitation in early myocardial infarction. Incidence, clinical detection, and prognostic implications. TIMI Study Group. Ann Intern Med. 1992; 117:10-17.

Barzilai B, Gessler C, Perez JE, Schaab C, Jaffe AS. Significance of Doppler detected mitral regurgitation in acute myocardial infarction. Am J Cardiol.1988;61:220-223.

Francesco G. Ischemic Mitral Regurgitation. Circulation. 2001; 103:1759.19. Francesca B, Maurice ES, Vuyisile TN, Steven JJ, Susan AW, Ryan M et al. Heart failure and Death After Myocardial Infarction in the community: The Emerging Role of Mitral regurgitation. Circulation.2005;111:295-301.

Calvo F.E. Mitral regurgitation complicating AMI. European Heart Journal.1997;18:1606-1610.

Feinberg MS, Schwammenthal E, Shlizerman L. Prognostic Significance of mild mitral regurgitation by color Doppler echocardiography in acute myocardial infarction. Am J Cardiol. 2000;86:903-907.

Wei JY. Hutchins GM, Bulkley BH. Papillary muscle rupture in fatal acute myocardial infarction. Ann Intern Med.1979;90:149-152.

Otsuji Y, Handschumacher MD, Schwammenthal E. Insights from three dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation .1997; 96 :1999-2008.

Hung J, Otsuji Y, Schwammenthal E, Levine RA. Mechanism of dynamic regurgitant Handschumacher orifice area variation infunctional mitral regurgitation: physiologic insights from the proximal flow convergenc technique.J Am Coll Cardiol. 1999; 33:538-545.

Mittal AK, Langston M, Cohn KE, Seizer A, Kerth W. Combined papillary muscle and left ventricular wall dysfunction as a cause of mitral regurgitation: an experimental study. Circulation.1971;44:174-180.

Llaneras MR, Nance ML, Streicher JT .Large animal model of ischemic mitral regurgitation. Ann Thora Surg. 1994; 57:432-441.

Kaul S, Spotnitz WD, Glasheen WP, Touchstone DA. Mechanism of Ischemic mitral regurgitation An experimental evaluation. Circulation. 1991 ;84:2167-2274.

Published
2018-10-09
How to Cite
Mawlood, F., & Al-Othman, A. (2018). Incidence and in-hospital complications of acute mitral regurgitation in the early phase of acute myocardial infarction in Erbil teaching hospital. Zanco Journal of Medical Sciences (Zanco J Med Sci), 16(2), 84-89. https://doi.org/10.15218/zjms.2012.0015
Section
Original Articles