Summary
Ischemic mitral regurgitation (IMR) is a frequent complication of left ventricular (LV) global or regional pathological remodeling due to chronic coronary artery disease. IMR is defined as mitral regurgitation (MR) caused by chronic changes of LV structure and function due to ischemic heart disease. It is not a valve disease but represents the valvular consequences of increased tethering forces and reduced closing forces (Piérard and Carabello ., 2010). It is reported in approximately one‑fifth of patients following acute myocardial infarction (MI) and one‑half of those with congestive heart failure ( Chaput et al., 2008). IMR is a frequent complication of coronary artery disease and it worsens the prognosis (Serri et al., 2006).
It is important to distinguish between primary MR due to organic disease of one or more components of the mitral valve apparatus and secondary MR which is not a valve disease, but represents LV disease. Secondary MR is defined as functional MR, due to LV remodeling by cardiomyopathy or coronary artery disease. In the latter clinical setting, secondary functional MR is called IMR. There are some limitations in this definition of functional IMR. Recent studies have revealed evidence of structural changes in the mitral leaflets in response to tethering on them by LV pathological remodeling. The leaflet adaptation includes enlargement and increased stiffness ( Chaput et al., 2008).
So, we aimed by this work to spot light on mitral valve tenting area and other echo parameters as apredictor of regression of ischemic mitral regurgitation in patient undergoing PCI.
The study was carried out on 100 patients with ischemic MR of both genders with age more than 18 years with with adequate imaging quality by trans thoracic echocardiography.
For all; after thorough history and clinical examination, echocardiographic parameters was taken before PCI and also on follow up after PCI .
The results were statistically analyzed and showed that:
1. The mean age was 56±7 years . Seventy six percent were males, 42% were hypertensives, 46% had history of DM, 44% were smokers, 58% were dyslipidemic and 32% had family history of premature CAD.
2. There is astatistically significantly difference between the cases regarding LVESV, LVEDV, LVEF and degree of MR pre and post catheterization (P >0.005).
3. The number of improved cases was 8 which represent 16% of the study population .
4. There is no astatistically significant difference between improved and non improved groups regarding age , gender , DM , hypertension , smoking & dyslipidemia (p0.005).
7. There is astatistically significant difference between improved and non improved groups regarding mitral valve tenting area (P>0.005).
8. There is no astatistically significant difference between improved and non improved groups regarding echo parameters ( LVESV , LVEDV & LVEF) (p |
