ISCHEMIC MITRAL REGURGITATION IN IRAQI PATIENTS: SINGLE CENTER EXPERIENCE

AL-SAFFAR H.¹*, AL-ZAIDEE M.R.O.², MUHAMMED S.M.^3
1Department of Medicine, Collage of Medicine, University of Baghdad, Iraq.
²Diploma Interventional Cardiology, Al Emam Ali Hospital, Baghdad Iraq.
³Human Resources Training & Development Centre, Baghdad, Iraq.
* Corresponding Author : crescent1957@yahoo.com

Received : 23-01-2014     Accepted : 24-03-2014     Published : 05-04-2014
Volume : 5     Issue : 1       Pages : 77 - 82
J Clin Res Lett 5.1 (2014):77-82
DOI : http://dx.doi.org/10.9735/0976-7061.5.1.77-82

Keywords : Ischemic mitral regurgitation, Ischemic heart diseases
Conflict of Interest : None declared

Mitral regurgitation (MR) is a relatively common finding in coronary heart disease. It increases morbidity and mortality particularly after myocardial infarction (MI). To estimate the prevalence of mitral valve regurgitation, assess its clinical and echocardiographic severity in patients with ischemic heart disease attending a single tertiary cardiac centre in Iraq, this study is conducted. One hundred fifty three patients, who were referred for cardiac evaluation of ischemic heart disease at Iraqi centre for heart disease in Baghdad between Jun 2011 and Jun 2012, were enrolled. Medical history, cardiac examination, ECG, trans-thoracic echocardiography and coronary angiography were done. Inclusion echocardiographic criteria were: normal mitral leaflets, normal other valves and significant angiographic coronary arteries lesions. Echocardiographic parameters include: ejection fraction and assessment of mitral regurgitation severity (if present) measured by jet area, venna contracta (VC) and proximal isovelocity surface area (PISA). Coronary angiography was done for all patients using standard views and significant CAD was defined as ≥50% diameter in left main stem artery (LMS) and 70% in other vessels, then patients were classified as having single, double and multi-vessels disease. Mitral regurgitation was detected by echocardiography in 45 patients (29.4%), while cardiac murmur, suggestive of mitral regurgitation, was found in only 9 of them (20%). The incidence of chronic ischemic mitral regurgitation (CIMR) is significantly more prevalent in patients with previous MI 29/73 patients (39.7%) P=0.04, hypertension 33/87 patients (37.9%) P=0.04 and in 41/71 patients with impaired LV systolic function (57.7%) P =0.0001, chronic ischemic mitral regurgitation were found in 28/62 (45.2%) of patients with multi-vessels diseases P=0.001. Chronic ischemic MR is common among patients with IHD referred for coronary angiography; clinically tend to be silent and more prevalent in patients with hypertension, previous MI, LV systolic dysfunction and multi-vessel diseases.

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