الفهرس | Only 14 pages are availabe for public view |
Abstract Ischemic mitral regurgitation (MR), often silent, is an important complication that adversely affects the patient’s prognosis in the chronic post-myocardial infarction. It is well established that the systolic mitral valve tenting is the main mechanism of ischemic MR due to apical and posterior papillary muscle displacements and that the annular dilation has only an adjunct role in the patients with chronic ischemic MR due to restricted motion, we hypothesized the possible existence of different echocardiographic subgroups of patients on the basis of tethering pattern. Therefore, we undertook an echocardiographic study to verify this hypothesis and to understand the possible differences in terms of local and global LV remodeling and characteristics of regurgitant jet. The aim of the work to detect the relation between the mechanism and degree of ischemic mitral regurgitation and mitral annular changes in post myocardial infarction ischemic mitral regurgitation. Patients The study was conducted on 24 patients with mitral regurgitation with history of postinfarction LV dysfunction, documented history of prior STEMI (ST segment elevation myocardial infarction) older than one week and show one or more LV segmental wall motion abnormalities, and structiorally normal MV leaflet and chorda tendinae in their echocardiography. We excluded from our study patients with History of known non ischaemic mitral regurgitation, non ischaemic LV dysfunction, LBBB, or RBBB, CABG. All studied group were subjected to: Meticulous history taking, Complete and cardiac examination and Resting 12 leads ECG. Resting transthoracic echocardiography, Two dimentional echocardiography, M-mode, Doppler echocardiography for evaluation of LV diastolic function, Doppler colour flow echocardiographic image for assessment of mitral regurgitation degree Assessment of mitral valve geometric deformation. |