Echocardiographic and Angiographic Prevalence of Ischemic Mitral Regurgitation

Background and Objectives: Ischemic mitral regurgitation is defined as regurgitation associated with significant stenosis of one or more of the coronary arteries and the absence of organic mitral valve disease. It is common sequela of coronary artery disease especially post-myocardial infarction. The aim of this study was to determine the prevalence of mitral regurgitation in patients with significant coronary artery stenosis using echocardiography and left ventricular angiography. Patients and methods: this study included patients attending Azadi Heart Center/Duhok/Iraq from 1st march 2018 to 1st march 2019 who underwent diagnostic coronary angiography and proved to have stenosis of 70% or more in at least one coronary branch, echocardiography, and left ventricular angiography were performed to detect mitral regurgitation. Results: Three hundred twelve patients were included in this study with a mean age of 60+2.06 years, 255 patients (81.7%) were male, and 57 patients (18.3%) were female. The prevalence of ischemic mitral regurgitation by echocardiography was statistically higher (33.7 %) compared to angiographic prevalence (20.1%; p<0.001). Mitral regurgitation was significantly more common in patients with multi-vessel disease, among 96 patients with multi-vessel diseases; 69 patients (71.8%) had ischemic mitral regurgitation (p<0.001). Conclusion: Ischemic mitral regurgitation is a relatively common complication of coronary artery disease, especially in those with multi-vessels disease and its frequency varies according to the method used for detection. Echocardiography is more sensitive than left ventricular angiography for detecting ischemic mitral regurgitation.