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Postinfarction ischemic mitral regurgitation in elderly and senile patients

Zhelnov V. V., Andreeva N. V., Shcheglova Yu. M., Komarova I. S.
State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bldg. 2, Moscow 119991

Keywords: myocardial infarction, mitral regurgitation, elderly age, senile age

DOI: 10.18087/rhfj.2014.1.1888

Background. Ischemic mitral regurgitation (IMR) plays an important role in development of HF and determines the prognosis in patients with myocardial infarction (MI). At present time, the mutual effect of IMR and LV systolic and diastolic function on development of HF is not known, especially in elderly and senile patients with acute MI. Our study evaluated the effect of IMR on the clinical course of acute MI in patients of different age groups. Materials and methods. 124 patients with acute Q-MI were evaluated. Patients were divided into two groups by age. Mean age of patients younger than 60 (mid-age group) was 45.4±6.8 years; mean age of patients older than 60 (older age group) was 71.3±6.1 years. Quantitative IMR variables were measured by the study standard EchoCG using two Doppler EchoCG methods: color Doppler mapping of the proximal isovelocity surface area (PISA) of regurgitation flow convergence and the method of quantitative Doppler-EchoCG (Q-DE method). Results. Acute HF (AHF) (Killip II–III) developed in 37.5 % of mid-age group patients with acute Q-MI, EF 47.9±6.60 % and mitral regurgitation fraction 20.14±7.9 %. In patients of the older age group with acute Q-MI, EF 47.7±6.5 % and mitral regurgitation fraction 20.3±6.4 %, AHF (Killip II–III) was observed in 73.5 % of cases (р=0.0001). Changes in the transmitral flow of the «impaired LV relaxation» type were observed in a greater proportion of older age group (80 %) than in the mid-age group (51.8 %) (р=0.006). Conclusion. In the acute period of MI, mild mitral regurgitation associated with typical age-related disturbance of LV relaxation results in clinically significant AHF (Killip II–III) in elderly and senile (older age group) patients twice as frequently as in younger patients (mid-age group).
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Zhelnov V. V., Andreeva N. V., Shcheglova Yu. M. et al. Postinfarction ischemic mitral regurgitation in elderly and senile patients. Russian Heart Failure Journal. 2014;15(1):9–13.

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