P3660Impact of left atrial dilatation on the progression of ischemic mitral regurgitation and the occurrence of adverse cardiovascular events in patients with acute myocardial infarction in circumflex arte

Introduction: Ischemic mitral regurgitation (IMR) is considered a ventricular myocardial disease caused by local remodeling after an acute myocardial infarction (AMI) of inferolateral location. There are very few studies that evaluate the factors that influence the progression of IMR. Left atrium (LA) dilatation may negatively affect to atrial and ventricular remodeling. Our aim is to determine the impact of LA dilatation at the time of AMI on the maintenance or progression of IMR after coronary revascularization and its probable relation with major adverse cardiovascular events (MACE). Methods: We included 126 patients (79.4% male; mean age of 62.8±13.8 years) with AMI whose responsible vessel was the circumflex artery (Cx). All the patients underwent an echocardiogram at admission and after 6 months in which we analyzed: the LA area and volume variables, the degree of mitral regurgitation, the effective regurgitant orifice (ERO) and left ventricular ejection fraction (LVEF). Patients with chronic mitral valve disease, calcified mitral valves and whose mitral valvular disease may be of organic origin were excluded. We evaluated the association between LA dilatation at the first echocardiogram with the echocardiographic data at 6-month and with MACE rate after a mean follow-up of 36 months (death from any cause, cardiac death, readmission for heart failure (HF) and stroke).