TY - JOUR
T1 - Pulsed Doppler echocardiographic analysis of mitral regurgitation after myocardial infarction
AU - Loperfido, Francesco
AU - Biasucci, Luigi M.
AU - Pennestri', Faustino
AU - Laurenzi, Francesco
AU - Gimigliano, Fabrizio
AU - Vigna, Carlo
AU - Rossi, Elisabetta
AU - Favuzzi, Angela
AU - Santarelli, Pietro
AU - Manzoli, Ugo
PY - 1986/10/1
Y1 - 1986/10/1
N2 - 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.
AB - 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.
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U2 - 10.1016/0002-9149(86)90339-5
DO - 10.1016/0002-9149(86)90339-5
M3 - Article
C2 - 3766410
AN - SCOPUS:0022898132
VL - 58
SP - 692
EP - 697
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 9
ER -