Abstract 3550: Ischemic Mitral Regurgitation and Tissue Doppler Imaging Derived Index of Left Ventricular Filling Pressure, E/E’, are Independent Predictors of Clinical Outcome in Patients with Ischemic Heart Disease
Background: Ischemic mitral regurgitation (IMR) has been shown to predict prognosis in patients with myocardial infarction.
Objective: The aim of this study was to investigate prognostic impact of IMR and tissue Doppler derived index of left ventricular filling pressure, E/E’, on long term clinical outcome in broad spectrum of ischemic heart disease (IHD).
Methods: A total of 524 patients with IHD patients were enrolled. Patients were categorized according to the presence or absence of severe IMR; group M (n=58) with severe IMR and group N (n=466) without.
Results: Group M was significantly older and had higher incidence of prior history of congestive heart failure (both p<0.01). By echocardiography, EF (43.0±14.6 % vs. 56.4±12.8 %, p<0.01) was significantly lower and E/E’ was significantly higher in group M than in group N (21.3±9.0 vs. 14.6±6.4, p<0.01). Cardiac events (cardiac death and congestive heart failure)-free survival rate was significantly lower in group M than in group N (Log-rank p<0.01, Figure⇓). By multivariate logistic regression analysis, E/E’> 15 (RR 3.49; 95%CI 2.08–5.88, p<0.0001), EF < 50% (RR 3.33; 95%CI 1.96–5.64, p<0.0001) and severe IMR (RR 2.34; 95%CI 1.22–2.48, p=0.01 ) were independent predictors of cardiac events.
Conclusion: IMR was a strong predictor of cardiac events independent of EF and E/E’ in patients with IHD.