The Journal of Thoracic and Cardiovascular Surgery
Volume 125, Issue 1 , Pages 135-143 , January 2003

Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: Quantitative analysis of left ventricular and mitral valve geometry in 103 patients with prior myocardial infarction

Received 7 February 2001 ,Accepted 17 July 2002.

References 

  1. Burch GE, De Pasquale NP, Phillips JH. Clinical manifestations of papillary muscle dysfunction. Arch Intern Med. 1963;112:112–117
  2. Phillips JH, Burch GE, De Pasquale NP. The syndrome of papillary muscle dysfunction: its clinical recognition. Ann Intern Med. 1963;59:508–520
  3. Rankin JS, Hickey MSJ, Smith LR, et al.  Ischemic mitral regurgitation. Circulation. 1989;79(suppl I):116–121
  4. Lehmann KG, Francis CK, Dodge HT, the TIMI Study Group . Mitral regurgitation in early myocardial infarction: incidence, clinical detection, and prognostic implications. Ann Intern Med. 1992;117:10–17
  5. Lamas GA, Mitchell GF, Flaker GC, et al.  Clinical significance of mitral regurgitation after acute myocardial infarction. Circulation. 1997;96:827–833
  6. Kisanuki A, Otsuji Y, Kuroiwa R, et al.  Two-dimensional echocardiographic assessment of papillary muscle contractility in patients with prior myocardial infarction. J Am Coll Cardiol. 1993;21:932–938
  7. Izumi S, Miyatake K, Beppu S, et al.  Mechanism of mitral regurgitation in patients with myocardial infarction: a study using real-time two-dimensional Doppler flow imaging and echocardiography. Circulation. 1987;76:777–785
  8. Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation. 2001;103:1759–1764
  9. Heikkila J. Mitral incompetence complicating acute myocardial infarction. Br Heart J. 1967;29:162–169
  10. Leor J, Feinberg MS, Vered Z, et al.  Effect of thrombolytic therapy on the evolution of significant mitral regurgitation in patients with a first inferior myocardial infarction. J Am Coll Cardiol. 1993;21:1661–1666
  11. Miller GE, Cohn KE, Kerth WJ, Selzer A, Gerbode F. Experimental papillary muscle infarction. J Thorac Cardiovsc Surg. 1968;56:611–616
  12. Mittal AK, Langston M, Cohn KE, Selzer A, Kerth WJ. Combined papillary muscle and left ventricular wall dysfunction as a cause of mitral regurgitation: an experimental study. Circulation. 1971;44:174–180
  13. Kaul S, Spotnitz WD, Glasheen WP, Touchstone DA. Mechanism of ischemic mitral regurgitation: an experimental evaluation. Circulation. 1991;84:2167–2180
  14. Godley RW, Wann LS, Rogers EW, Feigenbaum H, Weyman AE. Incomplete mitral leaflet closure in patients with papillary muscle dysfunction. Circulation. 1981;63:565–571
  15. Kono T, Sabbah HN, Rosman H, et al.  Mechanism of functional mitral regurgitation during acute myocardial ischemia. J Am Coll Cardiol. 1992;19:1101–1105
  16. Kono T, Sabbah HN, Stein PD, Brymer JF, Khaja F. Left ventricular shape as a determinant of functional mitral regurgitation in patients with severe heart failure secondary to either coronary artery disease or idiopathic dilated cardiomyopathy. Am J Cardiol. 1991;68:355–359
  17. Sabbah HN, Kono T, Rosman H, Jafri S, Stein PD, Goldstein S. Left ventricular shape: a factor in the etiology of functional mitral regurgitation in heart failure. Am Heart J. 1992;123:961–966
  18. Kono T, Sabbah HN, Rosman H, Alam M, Jafri S, Goldstein S. Left ventricular shape is the primary determinant of functional mitral regurgitation in heart failure. J Am Coll Cardiol. 1992;20:1594–1598
  19. Sabbah HN, Kono T, Stein PD, Mancini GBJ, Goldstein S. Left ventricular shape changes during the course of evolving heart failure. Am J Physiol. 1992;263:H266–H270
  20. Dent JM, Spotnitz WD, Nolan SP, Jayaweera AR, Glasheen WP, Kaul S. Mechanism of mitral leaflet excursion. Am J Physiol. 1995;269:H2100–H2108
  21. Otsuji Y, Handschumacher MD, Schwammenthal E, et al.  Insights from three-dimensional echocardiography into the mechanism of functional mitral regurgitation: direct in vivo demonstration of altered leaflet tethering geometry. Circulation. 1997;96:1999–2008
  22. Boltwood CM, Tei C, Wong M, Shah PM. Quantitative echocardiography of the mitral complex in dilated cardiomyopathy: the mechanism of functional mitral regurgitation. Circulation. 1983;68:498–508
  23. Komeda M, Glasson JR, Bolger AF, et al.  Geometric determinants of ischemic mitral regurgitation. Circulation. 1997;96(suppl II):II128–II133
  24. Matsuzaki M, Yonezawa F, Toma Y, et al.  Experimental mitral regurgitation in Ischemia-induced papillary muscle dysfunction. J Cardiol. 1988;18(Suppl 18):121–126
  25. Roberts R, Morris D, Pratt CM, Alexander RW. Pathophysiology, recognition, and treatment of acute myocardial infarction and its complications. In:  Schlant RC,  Alexander RW editor. The heart: arteries and veins. New York: McGraw-Hill Inc; 1994;p. 1137
  26. Segar DS, Brown SE, Sawada SG, Ryan T, Feigenbaum H. Dobutamine stress echocardiography: correlation with coronary lesion severity as determined by quantitive angiography. J Am Coll Cardiol. 1992;19:1197–1202
  27. Gorman JH, Gorman RC, Plappert T, et al.  Infarct size and location determine development of mitral regurgitation in the sheep model. J Thorac Cardiovasc Surg. 1988;115:615–622
  28. Schiller NB, Shah PM, Crawford M, et al.  Recommendations for quantification of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr. 1989;2:358–367
  29. D'Cruz IA, Shroff SG, Janicki JS, Jain A, Reddy HK, Lakier JB. Differences in the shape of the normal, cardiomyopathic, and volume overloaded human left ventricle. J Am Soc Echocardiogr. 1989;2:408–414
  30. Ormiston JA, Shah PM, Tei C, Wong M. Size and motion of the mitral valve annulus in man: I. A two-dimensional echocardiographic method and findings in normal subjects. Circulation. 1981;64:113–120
  31. Vijayaraghavan G, Boltwood CM, Tei C, Wong M, Shah PM. Simplified echocardiographic measurement of the mitral annulus. Am Heart J. 1986;112:985–991
  32. Liel-Cohen N, Guerrero JL, Otsuji Y, et al.  Design of a new surgical approach for ventricular remodeling to relieve ischemic mitral regurgitation: insights from 3-dimensional echocardiography. Circulation. 2000;101:2756–2763
  33. Otsuji Y, Handshumacher MD, Liel-Cohen N, et al.  Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction: three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation. J Am Coll Cardiol. 2001;37:641–648
  34. Helmcke F, Nanda NC, Hsiung MC, et al.  Color Doppler assessment of mitral regurgitation with orthogonal planes. Circulation. 1987;75:175–183
  35. Freed LA, Levy D, Levine RA, et al.  Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med. 1999;341:1–7
  36. Box GEP, Cox DR. An analysis of transformations. J R Stat Soc B. 1964;26:211–243
  37. Roberts R, Morris D, Pratt CM, Alexander RW. Pathophysiology, recognition, and treatment of acute myocardial infarction and its complications. In:  Schlant RC,  Alexander RW editor. The heart: arteries and veins. New York: McGraw-Hill Inc; 1994;p. 1115
  38. Yiu SF, Enriquez-Sarano M, Tribouilloy C, Seward JB, Tajik AJ. Determinants of the degree of functional mitral regurgitation in patients with systolic left ventricular dysfunction: a quantitative clinical study. Circulation. 2000;102:1400–1406
  39. Komeda M, Glasson JR, Bolger AF, et al.  Mirror image of “compensatory mechanism” of papillary muscles with posterior or anterior LV wall ischemia. Circulation. 1996;94(Suppl I):I-442
  40. Bach DS, Bolling SF. Improvement following correction of secondary mitral regurgitation in end-stage cardiomyopathy with mitral annuloplasty. Am J Cardiol. 1996;78:966–969
  41. Bach DS, Bolling SF. Early improvement in congestive heart failure after correction of secondary mitral regurgitation in end-stage cardiomyopathy. Am Heart J. 1995;129:1165–1170
  42. Rankin JS, Feneley MP, Hickey MS, et al.  A clinical comparison of mitral valve repair versus valve replacement in ischemic mitral regurgitation. J Thorac Cardiovasc Surg. 1988;95:165–177
  43. Hung J, Otsuji Y, Handschumacher MD, Schwammenthal E, Levine RA. Mechanism of dynamic regurgitation orifice area variation in functional mitral regurgitation: physiologic insights from the proximal flow convergence technique. J Am Coll Cardiol. 1999;33:538–545
  44. Liel-Cohen N, Otsuji Y, Vlahakes GJ, Akins CW, Levine RA. Functional ischemic mitral regurgitation can persist despite ring annuloplasty: mechanistic insights. Circulation. 1997;96(Suppl I):I-540

☆ Address for reprints: Yutaka Otsuji, MD, First Department of Internal Medicine, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520, Japan (E-mail: yutakam.kufm.kagoshima-u.ac.jp).

☆☆ 0022-5223/2003 $30.00+0

PII: S0022-5223(02)73325-4

doi: 10.1067/mtc.2003.78

The Journal of Thoracic and Cardiovascular Surgery
Volume 125, Issue 1 , Pages 135-143 , January 2003

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