Effects of Percutaneous Coronary Intervention on Ischemic Mitral Regurgitation

The management of ischemic mitral regurgitation represents a therapeutic challenge and is still controversial. The restoration of coronary blood flow reduces left ventricular remodeling and improves regional and global left ventricular function. This strategy is expected to attenuate ischemic mitral regurgitation. Our aim in this study is to evaluate the effect of successful total revascularization by PCI on the degree of ischemic mitral regurgitation. 50 patients with mild, moderate or severe ischemic MR were included in this study. All patients were subjected to proper clinical assessment, 12-lead ECG, transthoracic echocardiography before and 4 weeks after PCI. All of them underwent successful total PCI. There was a significant improvement in ischemic mitral regure IMR) degree after total revascularization using PCI for either single or multivessel disease in 58% of patients (p 0.05). The most important predictor of ischemic mitral regurgitation improvement post total PCI was revascularization of totally occluded coronary artery (p=0.030, Odds ratio= 11.8) and absence of DM (p=0.040, Odds ratio=5.5). In the present study, patients with multivessel disease had 83% of severe IMR and all of them improved after PCI. We conclude that successful total revascularization using PCI may improve ischemic mitral regurgitation whatever its degree.