Perez de Isla Leopoldo, Zamorano Jose, Martinez Quesada Mar, Corros Cecilia, Ortiz Pilar, Almeria Carlos, Rodrigo Jose Luis, Aubele Ada Lia, Fernández-Ortiz Antonio, Macaya Carlos
Instituto Cardiovascular, Hospital Clinico San Carlos, Madrid, Spain.
J Heart Valve Dis. 2005 Nov;14(6):742-8.
The development of mitral regurgitation (MR) soon after acute myocardial infarction (AMI) is a recognized and frequent complication. Its negative impact on survival has been observed after Q-wave AMI, even when of a mild degree, and independently of left ventricular systolic function. Few data exist regarding MR after non-Q-wave AMI (nQ AMI), however. Hence, the study aim was to investigate the incidence, clinical predictors and prognostic implications of MR in the setting of nQ AMI.
A total of 99 consecutive patients (37 men, 62 women; mean age 72 +/- 13 years) who suffered a nQ AMI was studied. All patients underwent echocardiography during the first week after the nQ AMI. MR was detected in 34 patients (17 men, 17 women; mean age 76 +/- 10 years). Events during follow up were coded as death, AMI, unstable angina, or heart failure. The in-hospital outcome was not significantly different between patients with and without MR. The mean follow up period was 663 +/- 574 days. In the univariate analysis, freedom from hospital survival was significantly greater in patients without MR. However, multivariate analysis showed that MR was not an independent predictor of cardiovascular hospitalization or death.
The incidence of MR is high among patients with nQ AMI but, unlike results found with Q-wave AMI, its presence does not add any prognostic significance to other known negative factors in the setting of nQ AMI.
急性心肌梗死（AMI）后不久发生二尖瓣反流（MR）是一种公认的常见并发症。在Q波型AMI后，即使程度较轻且与左心室收缩功能无关，也已观察到其对生存率有负面影响。然而，关于非Q波型AMI（nQ AMI）后MR的数据很少。因此，本研究的目的是调查nQ AMI情况下MR的发生率、临床预测因素及预后意义。
共研究了99例连续发生nQ AMI的患者（37例男性，62例女性；平均年龄72±13岁）。所有患者在nQ AMI后的第一周内接受了超声心动图检查。在34例患者（17例男性，17例女性；平均年龄76±10岁）中检测到MR。随访期间的事件被编码为死亡、AMI、不稳定型心绞痛或心力衰竭。有MR和无MR的患者住院结局无显著差异。平均随访期为663±574天。在单因素分析中，无MR的患者住院生存率显著更高。然而，多因素分析表明，MR不是心血管住院或死亡的独立预测因素。
nQ AMI患者中MR的发生率很高，但与Q波型AMI的结果不同，在nQ AMI情况下，其存在并未给其他已知的负面因素增加任何预后意义。
