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European Radiology

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15.01.2021 | Magnetic Resonance

Predictors of moderate to severe ischemic mitral regurgitation after myocardial infarction: a cardiac magnetic resonance study

verfasst von: Chen Zhang, Lei Zhao, Enjun Zhu, Paul Schoenhagen, Jie Tian, Yong-qiang Lai, Xiaohai Ma

Erschienen in: European Radiology | Ausgabe 8/2021

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Abstract

Objectives

The purpose of this study is to explore the predictors of moderate to severe ischemic mitral regurgitation (IMR) after myocardial infarction with cardiovascular magnetic resonance (CMR).

Methods

From January 2016 to September 2018, 109 patients (mean age 60 ± 8 years) with IMR were studied retrospectively. All patients underwent CMR-cine with True-FISP sequence and late gadolinium enhancement (LGE) with a phase-sensitive inversion recovery sequence. The presence of papillary muscle infarction (PMI), global left ventricular (LV) infarcted extent, LV functional parameters, and LV myocardial strain were assessed. Univariate and multivariate analyses were performed to identify factors in the development of moderate to severe IMR.

Results

Mild IMR was present in 61 patients (56%), and moderate to severe IMR was present in 48 patients (44%). PMI was identified in 22 patients (20.1%); 14 of them (63.63%) showed a moderate or severe IMR. Global LV infarcted extent was increased in patients with moderate to severe IMR (p < 0.001). LV functional parameters of patients with moderate to severe IMR were statistically different from those of the patients with mild IMR (all p < 0.001), except the LV SV index (p = 0.142) and LV CI (p = 0.447). The global longitudinal strain (GLS), regional radial strain (RS), and circumferential strain (CS) of the moderate-to-severe IMR group were significantly decreased compared with those of the mild IMR group (p < 0.05). In multivariable analyses, age (OR = 1.11; p = 0.001), global LV infarct extent (OR = 1.14; p = 0.000), and GLS (OR = 1.31; p = 0.000) were associated with moderate-to-severe chronic IMR.

Conclusions

The incidence of PMI was higher in patients with moderate-to-severe IMR. The extent of global LV infarcted extent and GLS were independent predictors of moderate-to-severe IMR.

Key Points

• Cardiovascular magnetic resonance late gadolinium enhancement and feature-tracking imaging provide reliable information on LV function, myocardial viability, and papillary muscle morphology.

• Papillary muscle infarction is not an independent predictor of moderate-to-severe IMR.

• The extent of global LV infarction and LV global longitudinal strain were independent predictors of moderate-to-severe chronic IMR.

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Titel: Predictors of moderate to severe ischemic mitral regurgitation after myocardial infarction: a cardiac magnetic resonance study
verfasst von: Chen Zhang
Lei Zhao
Enjun Zhu
Paul Schoenhagen
Jie Tian
Yong-qiang Lai
Xiaohai Ma
Publikationsdatum: 15.01.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07658-z

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Predictors of moderate to severe ischemic mitral regurgitation after myocardial infarction: a cardiac magnetic resonance study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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