Dominant hemodynamic parameters of chronic ischemic mitral regurgitation.

The study included 128 patients treated at the Institute of Cardiovascular Diseases in Sremska Kamenica within a year after the first posteroinferior myocardial infarction. On the basis of hemodynamic measurements, patients were divided into 2 groups. Group I (examinees) included 64 patients (58 males and 6 females, mean age 54.42 +/- 6.70 years) with proven mitral regurgitation and group 2 (control) included 64 patients (56 males and 8 females, mean age 51.71 +/- 8.84 years) without mitral regurgitation, but with stenotic changes in the right coronary artery and left circumflex coronary artery without significant stenotic lesions at the anterior descending left coronary artery. According to Sellers classification mitral regurgitation in group I was as follows: I grade 37.5%, II grade 31.3%, III grade 21.9% and IV grade 9.3%. Measured hemodynamic parameters in basal conditions (systolic, diastolic and mean pulmonary pressure, capillary pulmonary pressure and wave V, left ventricular end-diastolic pressure) point to significant impairment of diastolic function in group I apart from similar values of systolic function (cardiac output, cardiac index and ejection fraction). Dimension of the left atrium and left ventricle determined by transthoracic echocardiography confirm this. There was a positive correlation of examined parameters (pulmonary capillary and total pulmonary resistance) and the degree of mitral regurgitation, as well as the correlation between the degree of mitral regurgitation and hemodynamic parameters. It may be concluded that postinfarction mitral regurgitation in examined patients is of II degree on the average; total and capillary pulmonary resistance are most sensitive hemodynamic parameters for examining the severity of mitral regurgitation, whereas the size of the left atrium is the most sensitive echocardiographic parameter.