ANALYSIS OF THE OCCURRENCE AND COURSE OF SECONDARY ISCHEMIC MITRAL REGURGITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Introduction. One of the complications due to myocardial infarction is secondary mitral regurgitation, which occur from left atrial or left ventricular (LV) dysfunction or after the rupture of the mitral subvalvular apparatus. Ischemic secondary mitral regurgitation occurs in 7–32% of cases according to various literature sources. Due to its high frequency, it requires more detailed study. The aim – to study the frequency of secondary ischemic mitral regurgitation in patients with acute myocardial infarction based on angiography data and the time before revascularization. Materials and methods. The study included 149 patients with acute myocardial infarction. The following methods were used: general clinical examination, laboratory diagnostics, echocardiography, electrocardiography, and coronary angiography. Results. Among patients with mitral regurgitation, infarct-dependent involvement of the right coronary artery was predominant – 46 (45.54%) patients, p = 0.016, followed by the circumflex branch of the left coronary artery – 34 (33.66%) patients, p = 0.015. A higher percentage of multivessel disease was observed in patients with mitral regurgitation – 57 (56.44%), p = 0.031. Moreover, higher-grade ischemic mitral regurgitation was more frequently observed in patients who underwent revascularization > 12 hours after the onset of symptoms. Conclusions. Secondary ischemic mitral regurgitation in acute myocardial infarction was more commonly diagnosed in patients with infarct caused by right coronary artery lesions, followed by the circumflex branch of the left coronary artery. According to the obtained data, a longer duration from the onset of myocardial infarction symptoms tends to increase the degree of mitral regurgitation.