2026-06-26T20:49:27Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1007702025-07-03T13:57:14Zcom_20.500.14352_14col_20.500.14352_15

Núñez Gil, Iván J. Vivas Balcones, Luis David Viana Tejedor, Ana Teresa Escaned Barbosa, Javier Alfonso Manterola, Fernando García Fernández, Miguel Ángel Macaya Miguel, Carlos Fernández Ortiz, Antonio Ignacio 2024-02-09T09:41:35Z 2024-02-09T09:41:35Z 2013-08-19 Núñez-Gil IJ, Estrada I, Pérez de Isla L, et alFunctional mitral regurgitation after a first non-ST segment elevation acute coronary syndrome: very-long-term follow-up, prognosis and contribution to left ventricular enlargement and atrial fibrillation developmentHeart 2013;99:1502-1508. 1355-6037 1468-201X 10.1136/heartjnl-2013-304298 https://hdl.handle.net/20.500.14352/100770 https://heart.bmj.com/content/99/20/1502 https://pubmed.ncbi.nlm.nih.gov/23958756/ Objective To assess the relationship between functional mitral regurgitation (MR) after a non-ST segment elevation acute coronary syndrome (NSTSEACS) and long-term prognosis, ventricular remodelling and further development of atrial fibrillation (AF), since functional MR is common after myocardial infarction. Design and setting Prospective cohort study conducted in a tertiary referral centre. Patients We prospectively studied 237 patients consecutively discharged in New York Heart Association class I–II (74% men; mean age 66.1 years) after a first NSTSEACS. All underwent an ECG the first week after admission and were echocardiographically and clinically followed-up (median 6.95 years). Results MR was detected in 95 cases (40.1%) and became an independent risk factor for the development of heart failure (HF) and major adverse cardiovascular events (MACE) (per MR degree, HRHF 1.71, 95% CI 1.138 to 2.588, p=0.01; HRMACE 1.49, 95% CI 1.158 to 1.921, p=0.002). Left ventricular diastolic (grade I 12.7±40.7; grade II 26.8±12.4; grade III 46.3±50.9 mL, p=0.01) and systolic (grade I 10.4±37.3; grade II 10.12±12.7; grade III 36.8±46.0 mL, p=0.02) mean volumes were higher after follow-up in patients with MR, in proportion to the initial degree of MR. In the rhythm analysis (126 patients; previously excluding those with any history of AF) during follow-up, 11.4% of patients with degree I MR, 14.3% with degree II MR and 75% with degree III MR developed AF, while only 5.1% of those with degree 0 developed AF, p<0.001. Conclusions MR is common after an NSTSEACS. The presence and greater degree of MR confers a worse long-term prognosis after a first NSTSEACS. This can in part be explained by increased negative ventricular remodelling and increased occurrence of AF. eng restricted access Functional mitral regurgitation after a first non-ST segment elevation acute coronary syndrome: very-long-term follow-up, prognosis and contribution to left ventricular enlargement and atrial fibrillation development journal article