Factors associated with the presence of chronic mitral regurgitation in patients with stable coronary artery disease

Abstract

Aim. To assess the incidence of moderate systolic dysfunction in patients with stable coronary artery disease and determine the factors associated with it.Methods. 200 patients with coronary artery disease admitted to the Cardiology Department of the Research Institute for coronary artery bypass grafting were included in the study. Patients were assigned to two groups depending on the presence or absence of right ventricular systolic dysfunction (RVSD). Patients with RVSD (n = 30, 64 [59; 68] years), were assigned in Group 1, whereas patients without it (n = 170, 64 [60; 68] years) were assigned to Group 2.Results. Univariate logistic regression reported the following factors to be associated with RVSD: prior myocardial infarction (p = 0.098), chronic heart failure (p = 0.020), long smoking history (p = 0.003), increased left ventricular end-systolic and enddiastolic volumes (p = 0.005 and p = 0.004), decreased tricuspid annular plane systolic excursion (p <0.001), decreased early mitral flow propagation velocity (p = 0.027) and left ventricular ejection fraction (p = 0.002), significant circumflex artery stenosis (p = 0.075), right coronary artery occlusion (p = 0.073), singlevessel and three-vessel coronary artery disease (p = 0.055 and p = 0.014). Three multivariate models were generated. A decrease in the left ventricular ejection fraction (p = 0.009), three-vessel coronary artery disease (p = 0.055), and early mitral flow propagation velocity (p = 0.072) were considered as independent predictors of RVSD.Conclusion. Moderate RVSD was found in 15% of patients with stable coronary artery disease and preserved left ventricular function. A decrease in the left ventricular ejection fraction, but not damage to individual coronary arteries, the number of affected coronary arteries, the presence and localization of myocardial infarction were among the factors independently associated with right ventricular systolic function.