[The clinical significance of mitral insufficiency detected by Doppler echocardiography in acute myocardial infarct].
OBJECTIVE
To assess the clinical significance of mitral regurgitation (MR) diagnosed by pulsed Echo-Doppler in patients with acute myocardial infarction (AMI).


METHODS
Admission in a coronary care unit and a mean follow-up of 12 months.


METHODS
Seventy nine patients admitted in a coronary care unit, and 66 patients were followed-up for 12 months (mean).


METHODS
Pulsed Echo-Doppler were performed within three days after admission and the presence of MR was analyzed by apical four and two chamber views.


RESULTS
There were 62 males and 17 females (mean age: 61.4 +/- 10.8 (31-84) years). The location of AMI was: anterior--40, inferior--30, non-Q wave--6, indeterminate--2 and combined--1. Killip classes were: class I--50, class II--20, class III--7 and class IV--2. 17 patients had a previous AMI. The in-hospital mortality was 9 patients (12%) and the post-hospital mortality was 3 patients (4.5%). MR was detected in 24 patients (30%) in whom 14 (58%) had no murmur of MR previously auscultated. MR was considered moderate in 10 patients and mild in the others 14 patients. There were no significant statistical differences in the frequency of MR in relation to AMI location: anterior 57%, inferior 40% (chi 2 = 0.71, NS); to the presence of a previous AMI: 47% vs 26% (chi 2 = 1.93, NS); to age (61 vs 62 years). The patients with MR suffered a more serious degree of heart failure (class III + class IV): 29% vs 4% (chi 2 = 8.41, p < 0.005); higher hospital mortality: 29% vs 4% (chi 2 = 8.41, p < 0.005); and higher one year mortality: 37.5% vs 5.5% (chi 2 = 10.9, p < 0.001).


CONCLUSIONS
The presence of MR had no relationship with AMI location, the presence of a previous AMI or patients age. The patients with MR had a more serious degree of heart failure, higher hospital and one year mortality. The presence of MR detected by pulsed Echo-Doppler is a sign of bad prognosis although being auscultatory silent in a half of patients.
UTIC-Arsénio Cordeiro, Hospital de Santa Maria, Faculdade de Medicina, Lisboa, Portugal.
A L
AL
Bordalo e Sá
D S
DS
González
M G
MG
Léon
E P
EP
de Sá
F
F
Pais
A
A
Araújo
R
R
Ferreira
C
C
Ribeiro
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D011174:Portugal / Q000453:epidemiology; D012737:Sex Factors
Significado clínico da insuficiência mitral detectada por ecocardiografia-Doppler no enfarte agudo do miocárdio.