Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Oct-Dec;20(4):432-439.
doi: 10.4103/aca.ACA_58_17.

Ischemic mitral regurgitation

Praveen Kerala Varma  1 , Neethu Krishna  1 , Reshmi Liza Jose  2 , Ashish Narayan Madkaiker  1
Affiliations
Review

Ischemic mitral regurgitation

Praveen Kerala Varma et al. Ann Card Anaesth. 2017 Oct-Dec.

Abstract

Ischemic mitral regurgitation (IMR) is a frequent complication of left ventricular (LV) global or regional pathological remodeling due to chronic coronary artery disease. It is not a valve disease but represents the valvular consequences of increased tethering forces and reduced closing forces. IMR is defined as mitral regurgitation caused by chronic changes of LV structure and function due to ischemic heart disease and it worsens the prognosis. In this review, we discuss on etiology, pathophysiology, and mechanisms of IMR, its classification, evaluation, and therapeutic corrective methods of IMR.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Posterior and apical displacement of posterior-medial papillary muscle typically seen with infero-lateral akinesia or dykinesia at the base of the left ventricular. It causes tethering of posterior mitral leaflet leading to coaptation defect and posterior directed mitral regurgitation jet
Figure 2
Figure 2
The mitral regurgitation jet is seen in the posterior-medial commissure. Typically P2 and P3 segments are tethered causing the appearance of pseudo prolapsed of A2/A3 segments of anterior mitral leaflet
Figure 3
Figure 3
Transesophageal echocardiography LAX view showing restricted posterior mitral leaflet with tethering causing pseudo-prolapse of anterior mitral leaflet
Figure 4
Figure 4
Mitral regurgitation jet is posterior directed and wall hugging
Figure 5
Figure 5
Symmetric mitral regurgitation due to tethering of both leaflets. The left ventricular is spherical due to remodeling. This is typically seen in extensive old anterior wall infarction
Figure 6
Figure 6
Calculation of tenting area and height
Figure 7
Figure 7
Treatment algorithm for ischemic mitral regurgitation
See this image and copyright information in PMC

Comment in

References

    1. Piérard LA, Carabello BA. Ischaemic mitral regurgitation: Pathophysiology, outcomes and the conundrum of treatment. Eur Heart J. 2010;31:2996–3005. - PubMed
    1. Chaput M, Handschumacher MD, Tournoux F, Hua L, Guerrero JL, Vlahakes GJ, et al. Mitral leaflet adaptation to ventricular remodeling: Occurrence and adequacy in patients with functional mitral regurgitation. Circulation. 2008;118:845–52. - PMC - PubMed
    1. Bursi F, Enriquez-Sarano M, Nkomo VT, Jacobsen SJ, Weston SA, Meverden RA, et al. Heart failure and death after myocardial infarction in the community: The emerging role of mitral regurgitation. Circulation. 2005;111:295–301. - PubMed
    1. Lamas GA, Mitchell GF, Flaker GC, Smith SC, Jr, Gersh BJ, Basta L, et al. Clinical significance of mitral regurgitation after acute myocardial infarction. Survival and ventricular enlargement investigators. Circulation. 1997;96:827–33. - PubMed
    1. Serri K, Bouchard D, Demers P, Coutu M, Pellerin M, Carrier M, et al. Is a good perioperative echocardiographic result predictive of durability in ischemic mitral valve repair? J Thorac Cardiovasc Surg. 2006;131:565–73.e2. - PubMed

MeSH terms

LinkOut - more resources