Pulsed Doppler echocardiographic analysis of mitral regurgitation after myocardial infarction

Francesco Loperfido, Luigi M. Biasucci, Faustino Pennestri', Francesco Laurenzi, Fabrizio Gimigliano, Carlo Vigna, Elisabetta Rossi, Angela Favuzzi, Pietro Santarelli, Ugo Manzoli

Research output: Contribution to journalArticlepeer-review

Abstract

In 72 patients with previous myocardial infarction (MI), mitral regurgitation (MR) was assessed by pulsed-wave Doppler echocardiography and compared with physical and 2-dimensional echocardiographic findings. MR was found by Doppler in 29 of 42 patients (62%) with anterior MI, 11 of 30 (37%) with inferior MI (p <0.01) and in none of 20 normal control subjects. MR was more frequent in patients who underwent Doppler study 3 months after MI than in those who underwent Doppler at discharge (anterior MI = 83% vs 50%, p <0.01; inferior MI = 47% vs 27%, p = not significant). Of 15 patients who underwent Doppler studies both times, 3 (all with anterior MI) had MR only on the second study. Of the patients with Doppler MR, 12 of 27 (44%) with a left ventricular (LV) ejection fraction (EF) greater than 30% and 1 of 13 (8%) with an EF of 30% or less (p <0.01) had an MR systolic murmur. Mitral prolapse or aversion and papillary muscle fibrosis were infrequent in MI patients, whether or not Doppler MR was present. The degree of Doppler MR correlated with EF (r = -0.61), LV systolic volume (r = 0.47), and systolic and diastolic mitral anulus circumference (r = 0.52 and 0.51, respectively). Doppler MR was present in 24 of 28 patients (86%) with an EF of 40% or less and in 16 of 44 (36%) with EF more than 40% (p <0.001). The distal septum and anterobasal free wall were more frequently dyssynergic in patients with than in those without Doppler MR (difference significant for patients with anterior MI). Thus, (1) Doppler MR is common in patients with previous MI; (2) the murmur may be absent in patients with Doppler MR, particularly in those in whom EF is depressed; and (3) in patients with anterior MI, the degree of Doppler MR is inversely related to LV function.

Original languageEnglish
Pages (from-to)692-697
Number of pages6
JournalThe American Journal of Cardiology
Volume58
Issue number9
DOIs
Publication statusPublished - Oct 1 1986

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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