Authors

• Jozica Šikić — University Hospital “Sveti Duh”, Zagreb, Croatia — ORCID: 0000-0003-4488-0559

Keywords

coronary revascularization, coronary artery disease, secondary mitral regurgitation

DOI

Full Text

Introduction : Ischemic mitral regurgitation (MR) occurs frequently in patients with coronary artery disease (CAD) and is associated with an increased long-term risk ( 1 ). Moderate to severe MR is reported in 10-20% of patients with ischemic heart disease. Even mild MR in patients with ischemic heart disease is an independent predictor of adverse events, heart failure and mortality ( 2 ). The mechanism of ischemic MR is complex and consequence of a decompensating ventricle, not an intrinsic disease of the valve. Ischemic MR may be due to alterations in left ventricular geometry, distortion and enlargement of the mitral annulus or/and dyssynchrony of ventricular contraction which can cause disturbance of normal valve closure ( 3 ). The most important changes in ventricular geometry occur with infarction ( 4 ). Results : We included 686 patients with mitral regurgitation, 50% had CAD. Gender distribution showed that CAD is more frequent in men than women (62 vs 35%). One vessel disease was present in 34% of patients, while 27% of them had two-, and 39% had three vessel disease. According the MR severity, 62% of patients with CAD had mild MR, 30% moderate, and 8% severe MR. Among patients with severe MR, 41% had one-, 13% two-, and 45% had three vessel disease. Most of women had one vessel disease (47%), while men predominantly had three vessel disease (44%). Conclusion : The management is largely focused on medical therapy, and for those eligible, coronary revascularization or cardiac resynchronization therapy. It is extremely important to evaluate patients with non-invasive and invasive diagnostic procedures to find out who may have benefit from revascularization or valve repair only or both.