Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction.

Graham Scott Hillis, J. E. Moller, P. A. Pellikka, M. R. Bell, G. C. Casaclang-Veroza, J. K. Oh

    Research output: Contribution to journalArticle

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    Abstract

    Background There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues.

    Methods Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality.

    Results The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95% CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95% CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR.

    Conclusions Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.

    Original languageEnglish
    Pages (from-to)1268-1275
    Number of pages7
    JournalAmerican Heart Journal
    Volume150
    DOIs
    Publication statusPublished - 2005

    Keywords

    • DOPPLER-ECHOCARDIOGRAPHY
    • TRIAL

    Cite this

    Hillis, G. S., Moller, J. E., Pellikka, P. A., Bell, M. R., Casaclang-Veroza, G. C., & Oh, J. K. (2005). Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction. American Heart Journal, 150, 1268-1275. https://doi.org/10.1016/j.ahj.2005.01.020

    Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction. / Hillis, Graham Scott; Moller, J. E.; Pellikka, P. A.; Bell, M. R.; Casaclang-Veroza, G. C.; Oh, J. K.

    In: American Heart Journal, Vol. 150, 2005, p. 1268-1275.

    Research output: Contribution to journalArticle

    Hillis, Graham Scott ; Moller, J. E. ; Pellikka, P. A. ; Bell, M. R. ; Casaclang-Veroza, G. C. ; Oh, J. K. / Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction. In: American Heart Journal. 2005 ; Vol. 150. pp. 1268-1275.
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    title = "Prognostic significance of echocardiographically defined mitral regurgitation early after acute myocardial infarction.",
    abstract = "Background There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues.Methods Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality.Results The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95{\%} CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95{\%} CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR.Conclusions Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.",
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    AU - Moller, J. E.

    AU - Pellikka, P. A.

    AU - Bell, M. R.

    AU - Casaclang-Veroza, G. C.

    AU - Oh, J. K.

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    N2 - Background There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues.Methods Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality.Results The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95% CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95% CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR.Conclusions Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.

    AB - Background There are limited data regarding the clinical correlates and prognostic significance of echocardiographically defined mitral regurgitation (MR) early after acute myocardial infarction (MI). The current study addressed these issues.Methods Seven hundred thirty-seven patients with acute MI who underwent transthoracic echocardiography with assessment of MR during their index admission were identified. Patients were followed up a median of 19 months later. The study end point was all-cause mortality.Results The prevalence of MR increased with age. It was more common in women, in patients with non-ST-elevation MI, and in those with a history of diabetes, hypertension, prior MI, or previous revascularization. Patients with MR had worse left ventricular (LV) systolic function, more LV dilatation, and more clinical evidence of LV failure. Patients with moderate or severe MR had worse survival than those with no or mild MR (hazard ratio 2.3, 95% CI 1.6-3.2, P < .0001). Even mild MR predicted a higher mortality when compared with no MR (hazard ratio 1.7, 95% CI 1.2-2.4, P = .004). Mild or moderate MR was not independently predictive of outcome, although, in multivariable analyses, a trend toward worse survival was maintained in patients with severe MR.Conclusions Mitral regurgitation, identified by echocardiography, early after acute MI predicts poorer survival after acute MI. However, if mild or moderate, it is not an independent prognostic indicator.

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