LETTER
Mitral Regurgitation and MI Mortality
Olayinka F. Sogade and
Ernesto A. Jonas
1 March 1993 | Volume 118 Issue 5 | Pages 395-396
TO THE EDITOR:
Lehman and associates [1] raised the issue of poor prognosis and high mortality in patients with varying degrees of mitral regurgitation in the setting of myocardial infarction.
However, mitral regurgitation is mild in most such patients, and the prognosis appears to be related primarily to the degree of left ventricular dysfunction [1]. This is especially true of mitral regurgitation caused by mitral annular dilatation, which is at least as common in anterior wall infarcts as in posterior or inferior infarcts [2]. Thus, the mechanism is more important than the mere presence of mitral regurgitation, especially when mild.
Also, the attempt to group patients by severity of mitral regurgitation and related mortality is hampered by too small a sample size in the moderate-to-severe group. For example, one death among five patients translates to a mortality of 20% and a P value of less than 0.05 when measured at 10 days and at 1 year.
1. Izumi S, Miyatake K, Beppu S, Park YD, Nagata S, Kinoshita N, et al. Mechanism of mitral regurgitation in patients with myocardial infarction: a study using real-time two-dimensional Doppler flow imaging and echocardiography. Circulation. 1987; 76:777-85.
2. De Servi S, Vaccari L, Assandri J, Poma E, Cioffi P, Scire A, et al. Clinical significance of mitral regurgitation in patients with recent myocardial infarction. Eur Heart J. 1988; 9(Suppl F):5-9.
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