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Ann Thorac Surg. 2011 Nov;92(5):1614-20. doi: 10.1016/j.athoracsur.2011.05.117. Epub 2011 Sep 25.

Moderate mitral regurgitation accelerates left ventricular remodeling after posterolateral myocardial infarction.

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  • 1Veterans Affairs Medical Center, San Francisco, California 94121, USA.

Abstract

BACKGROUND:

Chronic ischemic mitral regurgitation (MR) is associated with poor outcome. However, the effect of chronic ischemic MR on left ventricular (LV) remodeling after posterolateral myocardial infarction (MI) remains controversial. We tested the hypothesis that moderate MR accelerates LV remodeling after posterolateral MI.

METHODS:

Posterolateral MI was created in 10 sheep. Cardiac magnetic resonance imaging was performed 2 weeks before and 2, 8, and 16 weeks after MI. Left ventricular and right ventricular volumes were measured, and regurgitant volume was calculated as the difference between LV and right ventricle stroke volumes.

RESULTS:

Multivariate mixed effects regression showed that LV volumes at end diastole and end systole and LV sphericity were strongly correlated with both regurgitant volume (p < 0.0001, p = 0.0086, and p = 0.0007, respectively) and percent infarct area (p = 0.0156, p = 0.0307, and p < 0.0001, respectively). Conversely, whereas LV hypertrophy (LV wall volume) increased from 2 weeks to 16 weeks after MI, there was no effect of either regurgitant volume or percent infarct.

CONCLUSIONS:

Moderate MR accelerates LV remodeling after posterolateral MI. Further studies are needed to determine whether mitral valve repair is able to slow or reverse MI remodeling after posterolateral MI.

PMID:
21945222
PMCID:
PMC3253877
DOI:
10.1016/j.athoracsur.2011.05.117
[PubMed - indexed for MEDLINE]
Free PMC Article
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