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Mitral regurgitation associated factors in women with ischemic heart disease without myocardial infarction

Kuznetsov V.A., Yaroslavskaya E.I., Krinochkin D.V., Pushkarev G.S., Marjinskikh L.V.

Keywords: women, CAD, mitral regurgitation

DOI: 10.18087/rhj.2013.6.1875

Background. Mitral regurgitation (MR) is known to be an independent predictor of cardiovascular death, which negatively influences prognosis in IHD patients. However the pathogenesis of MR in IHD patients without MI is understudied. Aim. Determining the factors related with chronic MR in women with IHD without MI. Materials and methods. Women with hemodynamically significant coronary stenosis (>75 % of lumen in at least one artery) without acute or past MI were selected among 16,839 patients included in the «Register of Performed Coronary Angiography Surgeries»: 183 female patients without MR and 20 female patients with moderate or severe MR. Results. Women with MR were older (61.2±8.9 years vs. 55.7±7.3 years, р=0.008); they more frequently had higher CHF NYHA FC (30 % vs. 17.1 %; р=0.033) and heart rhythm disorders (42.1 % vs. 12.3 %, р=0.001) with no significant difference in the prevalence of severe (III–IV FC) exertional angina. In women with MR, echoCG showed higher indices of left heart linear dimensions (left auricle, 23.5±3.0 mm / m² vs. 20.9±3.0 mm / m², р<0.001; LV, 27.1±2.8 vs. 25.1±2.5, р=0.006) and lower LV EF (56±4.6 vs. 60.2±4.6 %, р=0.001). Patients with MR less frequently had lesions in the anterior interventricular branch (59 % vs. 85 %, р=0.024). The multivariate analysis demonstrated that MR was independently related with heart rhythm disorders (OR=4.05; 95 % CI, 1.15–14.35, р=0.030), increased left atrial dimension index (OR=1.49; 95 % CI, 1.15–1.93, р=0.003), and lower LV EF (OR=0,86; 95 % CI, 0.76–0.96, р=0.008). Conclusion. In women with IHD without MI, MR is associated with heart rhythms disorders, increased left atrial dimension index, and reduced LV EF.
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Kuznetsov V.A., Yaroslavskaya E.I., Krinochkin D.V. et al. Mitral regurgitation associated factors in women with ischemic heart disease without myocardial infarction. Russian Heart Journal. 2013;12(6):360-364

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