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Mechanisms for development of ischemic mitral regurgitation

Chernyavsky A. M., Ruzmatov T. M., Efendiev V. U., Razumakhin R. A., Nesmachny A. S., Efanova O. S., Podsosnikova T. N., Volokitina T. L., Matveeva N. V., Prokhorova D. S.
Federal State Budgetary Institution, “Academician E.N. Meshalkin Novosibirsk Research Institute of Circulatory Pathology” of the RF Ministry of Health Care, Rechkunovskaya 15, Novosibirsk 630055

Keywords: coronary heart disease, ischemic mitral insufficiency, cardiomyopathy, heart failure

DOI: 10.18087/rhj.2015.2.1998

Background. Mechanisms for development of ischemic mitral regurgitation (IMR) in pronounced LV dysfunction and the relationship between the underlying mechanism and severity of mitral regurgitation (MR) have not been studied. Aim. To analyze results of the prospective, randomized study, which used data of transesophageal EchoCG (TEE), to determine mechanisms of MR in patients with pronounced LV dysfunction and IMR. Materials and methods. In the randomized study performed at the Novosibirsk Research Institute of Circulatory Pathology from 2005 through 2011, 230 patients with low LV EF and IMR of different severity were examined. The TEE study was used for evaluation of MR mechanisms and severity. Results. Geometry of the mitral valve (MV) and subvalvular structures and LV geometry and function were different in MR of different degrees. Analysis showed that no single, major mechanism of IMR development existed. A combination of several mechanisms induced by pathological LV remodeling is significant for the IMR pathogenesis – enlarged LV, increased interpapillary and annular-papillary distances, tension of MV leaflets, and expansion of the fibrous annulus.
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Chernyavsky A. M., Ruzmatov T. M., Efendiev V. U. et al. Mechanisms for development of ischemic mitral regurgitation. Russian Heart Journal. 2015;14 (1):85–89

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