Late Repair of Ischemic Mitral Regurgitation does not Prevent Left Ventricular Remodeling: Importance of Timing for Beneficial Repair

摘要

BackgroundIschemic mitral regurgitation (MR) is a frequent complication of myocardial infarction (MI) associated with left ventricular (LV) dilatation and dysfunction that doubles mortality. At the molecular level, moderate ischemic MR is characterized by a biphasic response with initial compensatory rise in pro-hypertrophic and anti-apoptotic signals followed by their exhaustion. We have shown that early MR repair 30 days after MI is associated with LV reverse remodeling. It is not known if MR repair performed after the exhaustion of compensatory mechanisms is also beneficial. We hypothesised that late repair will not result in LV reverse remodeling.