Predictors and prognostic impact of progressive ischemic mitral regurgitation in patients with advanced ischemic cardiomyopathy: A multimodality study

Deborah H. Kwon, Kenya Kusunose, Nancy A. Obuchowski, João L. Cavalcante, Zoran B. Popovic, James D. Thomas, Milind Y. Desai, Scott D. Flamm, Brian P. Griffin

Research output: Contribution to journalArticlepeer-review

Abstract

Background - Ischemic mitral regurgitation (IMR) is associated with poor outcomes. It is unknown what factors contribute to progression of IMR and how progressive IMR affects outcomes. We sought to determine imaging predictors of IMR progression and to determine if progressive IMR is an independent predictor of survival in patients with advanced ischemic cardiomyopathy. Methods and Results - Consecutive advanced ischemic cardiomyopathy patients who underwent cardiac magnetic resonance and echocardiograms at baseline with echocardiographic follow-up were studied. Cardiac magnetic resonance was used to assess left ventricular volumes, infarct size, and mitral valve geometry. The effective regurgitant orifice area (EROA) was calculated from the proximal isovelocity surface area by echocardiography. Repeated measures mixed effects and Cox proportional hazards regression models were built to identify predictors of IMR progression and survival. We evaluated 336 patients (age, 62±11 years) over a median follow-up time of 54 months: 154 patients were subsequently revascularized, and 182 patients were medically treated. Ninety-eight patients (29%) demonstrated an increase in EROA values of ≥0.1 cm2. There were 87 adverse events (death or transplant). On multivariable analysis, infarct size (P

Original languageEnglish (US)
JournalCirculation: Cardiovascular Imaging
Volume9
Issue number7
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Keywords

  • echocardiography
  • magnetic resonance imaging
  • mitral valve
  • myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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