Mėlinytė Karolina, Valuckiene Živile, Jurkevičius Renaldas
Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania.
Kardiol Pol. 2017;75(7):655-665. doi: 10.5603/KP.a2017.0059.
Ischaemic mitral regurgitation (IMR) is associated with adverse prognosis after myocardial infarction (MI) as a result of left ventricular remodelling and geometric deformation of the mitral apparatus (MA).
The aim of this study was to assess MA from anatomically correct imaging planes in acute inferoposterior MI and IMR.
Ninety-three patients with no structural cardiac valve abnormalities and the first acute inferoposterior MI were prospectively enrolled into the study. Two-dimensional transthoracic echocardiography for MA assessment was performed within 48 h of presentation after reperfusion therapy. Based on the degree of mitral regurgitation (MR), patients were divided into either a no significant MR (NMR) group (n = 52 with no or mild, grade 0-I MR) or an IMR group (n = 41 with grade ≥ 2 MR). The control group consisted of 45 healthy individuals.
Ischaemic MR was related with dilatation of the left ventricle chambers, decrease in ejection fraction, increase in mitral annulus diameter and area, and changes in subvalvular apparatus when compared with the NMR group or healthy individuals.
Ischaemic MR in acute inferoposterior MI is related with worse lesions in MA geometry that cause insufficiency of mitral valve function.
缺血性二尖瓣反流（IMR）与心肌梗死（MI）后的不良预后相关，这是由于左心室重构和二尖瓣装置（MA）的几何变形所致。
本研究的目的是在急性下后壁心肌梗死和IMR患者中，从解剖学正确的成像平面评估MA。
前瞻性纳入93例无结构性心脏瓣膜异常且首次发生急性下后壁心肌梗死的患者。在再灌注治疗后就诊的48小时内，进行二维经胸超声心动图评估MA。根据二尖瓣反流（MR）程度，将患者分为无明显MR（NMR）组（n = 52，无或轻度，0-I级MR）或IMR组（n = 41，≥2级MR）。对照组由45名健康个体组成。
与NMR组或健康个体相比，缺血性MR与左心室腔扩张、射血分数降低、二尖瓣环直径和面积增加以及瓣下装置改变有关。
急性下后壁心肌梗死中的缺血性MR与MA几何形状的更严重病变有关，这会导致二尖瓣功能不全。
