Frequency of Mitral Regurgitation after Acute St-Elevation Myocardial Infarction in Patients Presenting at Lady Reading Hospital
DOI:
https://doi.org/10.70749/ijbr.v3i7.1929Keywords:
Mitral regurgitation, ST-elevation myocardial infarction, ischemia, echocardiographyAbstract
Background: Ischemic mitral regurgitation (IMR) has become a well-known but severe side effect that occurs after acute ST-level span myocardial infarction (STEMI), causing a rise in morbidity levels and poor prognosis. Regardless of the improvement of reperfusion treatment techniques, a considerable proportion of affected patients still develops IMR because of the alteration of left ventricular geometry and abnormalities in local wall motion caused by the ischemia. In this study, the authors sought to establish the prevalence rate of IMR among patients admitted with acute STEMI to lady reading Hospital, Peshawar. Procedures: The study was conducted on a cross-sectional basis in the cardiology Department of Lady Reading Hospital. There were 185 consecutive patients without probability sampling aged between 30 to 75 years with confirmed acute STEMI who were enrolled. Patients with previous mitral regurgitation, rheumatic heart disease, repeated MI, and pregnancy were not included. IT was characterized by means of transthoracic echocardiography with normal morphology of the mitral valve and regional wall movements as a complication of coronary artery disease. The SPSS version 25 was used to analyze data. Relationships with clinical variables were measured using stratification and chi-square testing. Results: Among 185 patients, 70 patients (37.8%) encountered the development of ischemic mitral regurgitation. IMR had significant association with older age of age 60 years and above ( p=0.019), female gender ( p=0.041), BMI of 25kg/m2 and above ( p=0.032), hypertension ( p=0.008), and diabetes mellitus ( p=0.003). They were not significantly associated with smoking, socioeconomic status or residence. Closure: IMR is a common complication associated with STEMI especially in the older, hypertensive, diabetic, and overweight population. An immediate heart ultrasound assessment and selective treatment of risk factors are needed to enhance the prognosis of STEMI patients.
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1. Ye, J., Yuan, R., Liu, Y., Wang, W., Xu, D., Li, Y., ... & Zong, G. (2025). A nomogram risk prediction model for ischemic mitral regurgitation after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. European Journal of Medical Research, 30(1), 357.
https://doi.org/10.1186/s40001-025-02624-1
2. Sharma, H., Yuan, M., Shakeel, I., Hodson, J., Radhakrishnan, A., Brown, S., ... & Nadir, M. A. (2022). A longitudinal study of mitral regurgitation detected after acute myocardial infarction. Journal of clinical medicine, 11(4), 965.
https://doi.org/10.3390/jcm11040965
3. Nappi, F. (2024). Comparing surgical techniques and results of secondary ischemic mitral regurgitation: A state-of-the-art literature review. Annals of Translational Medicine, 12(5), 91.
https://doi.org/10.21037/atm-24-39
4. Tesic, M., Travica, L., Giga, V., Jovanovic, I., Trifunovic Zamaklar, D., Popovic, D., ... & Djordjevic Dikic, A. (2023). Prognostic value of mitral regurgitation in patients with primary hypertrophic cardiomyopathy. Medicina, 59(10), 1798.
https://doi.org/10.1161/jaha.120.021936
5. Ye, J., Yuan, R., Liu, Y., Wang, W., Xu, D., Li, Y., ... & Zong, G. (2025). A nomogram risk prediction model for ischemic mitral regurgitation after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. European Journal of Medical Research, 30(1), 357.
https://doi.org/10.1186/s40001-025-02624-1
6. Liang, J., & Zhang, Z. (2023). Predictors of in-hospital heart failure in patients with acute anterior wall ST-segment elevation myocardial infarction. International journal of cardiology, 375, 104-109.
https://doi.org/10.1016/j.ijcard.2023.01.002
7. Anghel, L., Tudurachi, B. S., Leonte, A., Sascău, R. A., Zota, I. M., Bazyani, A., ... & Stătescu, C. (2022). The challenge of high coronary thrombotic events in patients with ST-segment elevation myocardial infarction and COVID-19. Journal of Clinical Medicine, 11(21), 6542.
https://doi.org/10.3390/jcm11216542
8. Trimarchi, G., Pizzino, F., Lilli, A., De Caterina, A. R., Esposito, A., Dalmiani, S., ... & Paradossi, U. (2024). Advanced lung cancer inflammation index as predictor of all-cause mortality in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Journal of Clinical Medicine, 13(20), 6059.
https://doi.org/10.3390/jcm13206059
9. Murphy, A., & Goldberg, S. (2022). Mechanical complications of myocardial infarction. The American journal of medicine, 135(12), 1401-1409.
https://doi.org/10.1016/j.amjmed.2022.08.017
10. Boudoulas, K. D., Triposkiadis, F., Koenig, S., Marmagkiolis, K., Iliescu, C., Pitsis, A., & Boudoulas, H. (2023). Acute mitral regurgitation with and without acute heart failure. Heart Failure Reviews, 28(5), 1201-1209.
https://doi.org/10.1007/s10741-023-10322-5
11. Heusch, G. (2022). Coronary blood flow in heart failure: cause, consequence and bystander. Basic research in cardiology, 117(1), 1.
https://doi.org/10.1007/s00395-022-00909-8
12. Huang, A. L., Dal-Bianco, J. P., Levine, R. A., & Hung, J. W. (2023). Secondary mitral regurgitation: cardiac remodeling, diagnosis, and management. Structural Heart, 7(3), 100129.
https://doi.org/10.1016/j.shj.2022.100129
13. Kumar, M., Thompson, P. D., & Chen, K. (2023). New perspective on pathophysiology and management of functional mitral regurgitation. Trends in Cardiovascular Medicine, 33(6), 386-392.
https://doi.org/10.1016/j.tcm.2022.03.001
14. Adamo, M., Chioncel, O., Pagnesi, M., Bayes‐Genis, A., Abdelhamid, M., Anker, S. D., ... & Metra, M. (2024). Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC. European journal of heart failure, 26(1), 18-33.
https://doi.org/10.1002/ejhf.3106
15. Leancă, S. A., Crișu, D., Petriș, A. O., Afrăsânie, I., Genes, A., Costache, A. D., ... & Costache, I. I. (2022). Left ventricular remodeling after myocardial infarction: from physiopathology to treatment. Life, 12(8), 1111.
https://doi.org/10.3390/life12081111
16. He, M., Li, Y., Zhu, D., Li, J., Cangu, M., Tasoudis, P., ... & Huang, K. (2025). Stromal-platelet membrane-inspired nanoparticles (SPIN) for targeted heart repair. Bioactive Materials, 53, 45-57.
https://doi.org/10.1016/j.bioactmat.2025.06.055
17. Malagoli, A., Rossi, L., Zanni, A., Sticozzi, C., Piepoli, M. F., & Benfari, G. (2022). Quantified mitral regurgitation and left atrial function in heart failure with reduced ejection fraction: interplay and outcome implications. European Journal of Heart Failure, 24(4), 694-702.
https://doi.org/10.1002/ejhf.2429
18. Simpson, T. F., Kumar, K., Samhan, A., Khan, O., Khan, K., Strehler, K., ... & Zahr, F. (2022). Clinical predictors of mortality in patients with moderate to severe mitral regurgitation. The American Journal of Medicine, 135(3), 380-385.
https://doi.org/10.1016/j.amjmed.2021.09.004
19. Falcão‐Pires, I., Ferreira, A. F., Trindade, F., Bertrand, L., Ciccarelli, M., Visco, V., ... & Tocchetti, C. G. (2024). Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function. European journal of heart failure, 26(7), 1454-1479.
https://doi.org/10.1002/ejhf.3264
20. Babes, E. E., Tit, D. M., Bungau, A. F., Bustea, C., Rus, M., Bungau, S. G., & Babes, V. V. (2022). Myocardial viability testing in the management of ischemic heart failure. Life, 12(11), 1760.
https://doi.org/10.3390/life12111760
21. Bansal, K., Gore, M., Afzal, M., Shams, P., & Nalabothu, P. (2024). Anterior myocardial infarction. In StatPearls [Internet]. StatPearls Publishing.
22. Beyls, C., Hermida, A., Nicolas, M., Debrigode, R., Vialatte, A., Peschanski, J., ... & Leborgne, L. (2024). Left atrial strain analysis and new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction: A prospective echocardiography study. Archives of cardiovascular diseases, 117(4), 266-274.
https://doi.org/10.1016/j.acvd.2024.01.002
23. Venkatram, P. (2024). Myocardial Ischemia and Infarction: Echocardiographic Changes, Segmental Wall Motion Changes, Complications and Treatment Options. Stress Echocardiography. In Heart Diseases and Echocardiogram: Principles in Practice (pp. 395-411). Cham: Springer Nature Switzerland.
https://doi.org/10.1007/978-3-031-59246-1_21
24. Moras, E., Yakkali, S., Gandhi, K. D., Virk, H. U. H., Alam, M., Zaid, S., ... & Krittanawong, C. (2024). Complications in acute myocardial infarction: Navigating challenges in diagnosis and management. Hearts, 5(1), 122-141.
https://doi.org/10.3390/hearts5010009
25. Nägele, M. P., & Flammer, A. J. (2022). Heart failure after right ventricular myocardial infarction. Current Heart Failure Reports, 19(6), 375-385.
https://doi.org/10.1007/s11897-022-00577-8
26. Geisser, D. L., & Singh, M. N. (2025). Mitral valve and left atrial abnormalities. In Nadas' Pediatric Cardiology (pp. 433-446). Elsevier.
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