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首页> 外文期刊>Journal of Korean medical science >The Prognostic Value of the Left Ventricular Ejection Fraction Is Dependent upon the Severity of Mitral Regurgitation in Patients with Acute Myocardial Infarction
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The Prognostic Value of the Left Ventricular Ejection Fraction Is Dependent upon the Severity of Mitral Regurgitation in Patients with Acute Myocardial Infarction

机译：急性心肌梗死患者左室射血分数的预后价值取决于二尖瓣反流的严重程度

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The prognostic value of the left ventricle ejection fraction (LVEF) after acute myocardial infarction (AMI) has been questioned even though it is an accurate marker of left ventricle (LV) systolic dysfunction. This study aimed to examine the prognostic impact of LVEF in patients with AMI with or without high-grade mitral regurgitation (MR). A total of 15,097 patients with AMI who received echocardiography were registered in the Korean Acute Myocardial Infarction Registry (KAMIR) between January 2005 and July 2011. Patients with low-grade MR (grades 0-2) and high-grade MR (grades 3-4) were divided into the following two sub-groups according to LVEF: LVEF <= 40% (n=2,422 and 197, respectively) and LVEF > 40% (n=12,252 and 226, respectively). The primary endpoints were major adverse cardiac events (MACE), cardiac death, and all-cause death during the first year after registration. Independent predictors of mortality in the multivariate analysis in AMI patients with low-grade MR were age >= 75 yr, Killip class >= III, N-terminal pro-B-type natriuretic peptide > 4,000 pg/mL, high-sensitivity C-reactive protein >= 2.59 mg/L, LVEF <= 40%, estimated glomerular filtration rate (eGFR), and percutaneous coronary intervention (PCI). However, PCI was an independent predictor in AMI patients with high-grade MR. No differences in primary endpoints between AMI patients with high-grade MR (grades 3-4) and EF <= 40% or EF > 40% were noted. MR is a predictor of a poor outcome regardless of ejection fraction. LVEF is an inadequate method to evaluate contractile function of the ischemic heart in the face of significant MR.
机译：急性心肌梗死（AMI）后左心室射血分数（LVEF）的预后价值受到质疑，即使它是左心室（LV）收缩功能障碍的准确标志。这项研究旨在检查LVEF对患有或不伴高度二尖瓣关闭不全（MR）的AMI患者的预后影响。在2005年1月至2011年7月之间，韩国急性心肌梗死登记处（KAMIR）共登记了15097例接受超声心动图检查的AMI患者。MR为低度（0-2级）和MR为高度（3级） 4）根据LVEF分为以下两个子组：LVEF <= 40％（分别为n = 2,422和197）和LVEF> 40％（分别为n = 12,252和226）。主要终点是注册后第一年的主要不良心脏事件（MACE），心脏死亡和全因死亡。低度MR AMI患者多因素分析中死亡率的独立预测因素是年龄> = 75岁，基利普等级> = III，N端前B型利尿钠肽> 4,000 pg / mL，高敏感性C-反应蛋白> = 2.59 mg / L，LVEF <= 40％，估计的肾小球滤过率（eGFR）和经皮冠状动脉介入治疗（PCI）。但是，PCI是AMI合并高级别MR的独立预测因子。并没有发现MR≥3-4级和EF <= 40％或EF> 40％的AMI患者的主要终点差异。无论射血分数如何，MR都是不良结局的预测因子。 LVEF不足以评估面对严重MR的缺血性心脏的收缩功能。

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