Russian Heart Failure Journal 2007year Mitral regurgitation and myocardial remodeling
Mitral regurgitation and myocardial remodeling
Sergeeva L. I.
Urgency. Mitral regurgitation (MR) pathogenetically closely linked with LV myocardial remodeling is considered a leading factor along with myocardial ischemia in progression of LV systolo-diastolic dysfunction in patients with IHD. Aim: To evaluate MR-related peculiarities of structural and functional state in the left and right heart of patients with IHD in the course of progressing diastolic dysfunction (DD). Materials and methods. 48 patients with post-infarction cardiosclerosis and I–IV NYHA class CHF were evaluated including structural and functional assessment of left and right heart divisions at different stages of LV DD using data of Doppler echoCG. Regurgitant flow rate, MR degree and hemodynamic significance were determined. Results. At the phase of slow myocardial relaxation with normal LV filling pressure, MR prolonged the flow slowing time of LV early diastolic filling. In further progression of DD and high filling pressure, MR was associated with chamber dilation, reduced contractility, increased myocardial mass and elevated pulmonary arterial pressure. The absence of MR in the restrictive type of DD was associated with less pronounced myocardial remodeling and lower CHF FC.