Left Ventricular Remodeling is Less While Left Atrial Remodeling is Greater in Inferior Compared to Anterior Myocardial Infarction: Importance of Ischemic Mitral Regurgitation

• Arikawa Kiyotake

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Otsuji Yutaka

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Zhang Hui

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Yu Bo

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Uemura Takeshi

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Hamasaki Shuichi

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Biro Sadatoshi

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Kisanuki Akira

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Minagoe Shinichi

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

• Tei Chuwa

  Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University

Abstract

Background. Left ventricular (LV) remodeling is greater in patients with anterior myocardial infarction (MI) compared to those with inferior MI. Left atrial (LA) remodeling is expected to have influences from both LV remodeling and mitral valve dysfunction or mitral regurgitation (MR), which is more frequent in inferior MI. Therefore, LA remodeling may not necessarily be less in inferior MI compared to anterior MI. The purpose of the study is comparison of LV and LA remodeling in patients with anteroseptal and inferior MI with or without MR.<br>Methods. In 61 consecutive patients with prior anterior MI, 33 with prior inferior MI, and 22 normal control subjects, LV and LA volumes were measured using biplane Simpson's method, and MR fraction was quantified by Doppler echocardiography.<br>Results. Although patients with inferior MI had significantly less LV dilatation (LV end-diastolic volume: 91±11 vs. 125±45 vs. 106±19 ml, control vs. anterior vs. inferior, p<0.01) and reduction in LV ejection fraction (63±6 vs. 44±7 vs. 49±8 %, p<0.01), their LA dilatation was significantly greater compared to those with anterior MI (51±12 vs. 64±28 vs. 78±31 ml, p<0.01). Incidence of ischemic MR (fraction>20%) was significantly higher in patients with inferior MI compared to anterior MI (7/61 vs. 12/33, p<0.01). In selected patients without significant ischemic MR, LA dilatation was comparable between inferior and anterior MI (60±28 vs. 61±16 ml, n.s.).<br>Conclusions. Compared to patients with anterior MI, LV remodeling is significantly less but LA remodeling is significantly greater in inferior MI, suggesting the important role of ischemic MR to induce LA remodeling.

Journal

• Journal of Echocardiography

  Journal of Echocardiography 2 (2), 43-48, 2004

  Japanese Society of Echocardiography

Keywords

• echocardiography
• left atrial remodeling
• mitral regurgitation

Details

• CRID: 1390001205232051712
• NII Article ID: 10027297364
• NII Book ID: AA12042477
• DOI: 10.2303/jecho.2.43
• ISSN: 1880344X
• ISSN: 13490222
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed