Predictors and Prognostic Impact of Progressive Ischemic Mitral Regurgitation in Patients With Advanced Ischemic Cardiomyopathy

Ischemic mitral regurgitation (IMR) as a result of myocardial infarction (MI) has been shown to be an extremely powerful independent predictor of heart failure and death. Although increasing IMR severity has been shown to be significantly associated with increasing mortality, significant left ventricular (LV) dilation, systolic dysfunction, and myocardial scar burden likely contribute to the progression of IMR, and they have also been shown to be powerful imaging predictors of adverse events in patients with ischemic cardiomyopathy (ICM). IMR may become more severe with adverse remodeling during followup, and as a result, further adverse remodeling likely ensues. Therefore, we sought to determine the prognostic importance of LV remodeling, subsequent treatment, and IMR progression during follow-up, in patients with advanced ICM after adjusting for important imaging and clinical parameters.