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(Circulation. 2005;111:254-256.)
© 2005 American Heart Association, Inc.

Editorial

Ischemic Mitral Regurgitation and Its Related Risk After Myocardial Infarction

Tushar V. Salukhe, BSc, MRCP; Michael Y. Henein, MD, MSc, PhD; Richard Sutton, DSc(Med)

From the National Heart & Lung Institute, Imperial College, and the Royal Brompton Hospital, London, United Kingdom.

Correspondence to Prof Richard Sutton, Pacing and ICD Dept, Royal Brompton Hospital, Sydney St, London SW3 6NP, UK. E-mail r.sutton@rbh.nthames.nhs.uk

Key Words: Editorials • myocardial infarction • regurgitation • ischemia • risk

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In this issue of Circulation, Bursi et al¹ report that ischemic mitral regurgitation is a more common finding after myocardial infarction (MI) than was previously thought and is an independent predictor of heart failure and death among 30-day infarct survivors. Seldom is mitral regurgitation actively investigated, and investigation is often only prompted by clinical examination. The data Bursi et al report support findings from the 1970s, which suggested that clinical examination is not sensitive in the detection and assessment of mitral regurgitation.² The authors conclude that Doppler echocardiographic assessment of mitral regurgitation should be actively sought and included in post-MI risk stratification.

See p 295

	Ischemic Mitral Regurgitation and Prognosis After MI

 
Early invasive studies demonstrated an association between mitral regurgitation and increased 1-year mortality. Tcheng et al³ reported a mitral regurgitation prevalence of 17% in 255 patients. One-year mortality rates showed a graded association with the degree of mitral regurgitation: 11%, 22%, and 52% in patients with no regurgitation, angiographic grade 1 to 2 regurgitation, and grade 3 to 4 regurgitation, respectively. When clinical confounders were adjusted for by multivariate analysis, only grade 3 to 4 mitral regurgitation carried a significantly increased 1-year mortality risk. A similarly designed study reported a post-MI mitral regurgitation prevalence of 13% and showed that mitral regurgitation predicted cause-specific cardiovascular mortality.⁴ The larger SAVE (Survival and Ventricular Enlargement)⁵ study of 727 patients reported that even mild (grade 1 to 2) ischemic mitral regurgitation was an independent predictor of cause-specific post-MI cardiovascular mortality.

Echocardiographic studies of ischemic mitral regurgitation also have . . . [Full Text of this Article]

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