Real-time three-dimensional echocardiography evaluation of mitral valve configuration in patients with acute myocardial infarction and moderate mitral regurgitation before and after PCI

  AIM  To evaluate the changes of mitral valve configuration in AMI patients with moderate mitral regurgitation before and after percutaneous coronary intervention (PCI) by real-time three-dimensional echocardiography (RT3D-TTE), and to predict the improvement of mitral regurgitation after PCI.

  METHODS  90 patients with acute myocardial infarction and moderate mitral regurgitation who underwent PCI in Baoding first central hospital were selected. According to the improvement of mitral regurgitation 3 months after operation, the patients were divided into two groups: no improvement group (n=37) and improvement group (n=53). Logistic regression method was used to screen the related parameters that affect the situation of no improvement of reflux after PCI, and to predict the improvement efficiency.

  RESULTS  The following indexes were detected: height of annulus (AH), volume of tentorial area (TV), three-dimensional area of annulus (AA_3D), diameter of annulus junction (CD), circumference of annulus (AC), anterolateral to posteromedial diameter of annulus (AL-PM), anterolateral and anterolateral diameter of annulus (AP). There was no significant difference in AH, TV, AA_3D, CD, AC, AL-PM between the two groups, AP was lower than that before operation (P< 0.05); ah in the improved group was higher than that before operation, TV, AA_3D, CD, AC, AL-PM and AP were lower than those before operation (P < 0.05); AA_3D, CD, AC, AL-PM and AP in the improved group were lower than those in the non improved group (P < 0.05), TV, AA_3D, CD, AC, AL-PM and AP in the improved group were lower than those in the non improved group (P < 0.05) The results of multivariate analysis showed that CD, AC, AL-PM and AP were closely related to the unrewarded reflux after PCI (P < 0.05); the sensitivity, specificity and accuracy of mitral valve parameters in evaluating unrewarded reflux after PCI were as follows: CD: 76%, 64% and 69%; AC: 78%, 64% and 70%; AL-PM: 78%、74% and 76%; AP: 84%、83% and 83%.

  CONCLUSION   RT3D-TTE examination can grasp the characteristics of mitral valve configuration in patients with acute myocardial infarction and moderate mitral regurgitation, and predict the improvement of mitral regurgitation after PCI.