PREDICTORS OF THE DEVELOPMENT OF MITRAL INSUFFICIENCY IN ACUTE MYOCARDIAL INFARCTION AND THEIR INFLUENCE ON PATIENT SURVIVAL
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i1.14536Keywords:
myocardial infarction, mitral insufficiency, predictors, lethalityAbstract
SUMMARY. In patients with acute myocardial infarction, the development of mitral insufficiency is a frequent complication that worsens the course of the disease.
The aim – to identify predictors of mitral valve development insufficiency in patients with acute myocardial infarction with reduced LV ejection fraction.
Material and Methods. In this study, it was used general clinical examination of patients, laboratory diagnostics, echocardiography, electrocardiography, coronary angiography and statistical method of information analysis.
Results. According to the analysis of the obtained results, it is heart attack-dependent lesion of the circumflex artery most often was accompanied by the development of mitral insufficiency with an average of 2.972 (95 % confidence interval 1.207–7.322; p=0.018), in second place is the right coronary artery, where the odds ratio indicator is reliably 2.509 with 95 % confidence interval 1.171–5.374, p=0.018. According to coronary angiography, multivessel damage is one of the factors which increases the odds ratio of mitral regurgitation with odds ratio 2.159 with 95 % confidence interval 1.067–4.367, p=0.032. When assessing the perfusion of the infarct dependent artery after the point of occlusion during coronary angiography, absence of antegrade blood flow is prognostically unfavorable for patients and with a high probability was accompanied by functional impairment mitral valve (odds ratio 5.744 with 95 % confidence interval 0.720–45.856, p=0.099). Analyzing the mortality of patients – 2 patients (4.17 %) without impairmentmitral valve function and 8 (7.92 %) with mitral insufficiency.
Conclusions. Therefore, prognostic criteria with high the odds ratio for the occurrence of myocardial infarction in patients is infarct-dependent damage to the circumflex artery, somewhat less likely – right coronary artery, presence multivessel lesions according to the results of coronary angiography and disorders of antegrade blood flow below the site of occlusion after revascularization. According to of the obtained data, the development of mitral insufficiency in acute myocardial infarction with a reduced left ventricle ejection fraction reduces the chances of survival.
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