Definition for Ischemic Mitral Regurgitation

 

NOTE: The original definition is for moderate disease. I have attempted to modify this to encompass the spectrum of disease.

 

Criteria:

(1) Evidence of significant symptomatic multivessel coronary artery disease, with or without documented myocardial infarction but the patient should not be actively ischemic.

(2) Absence of mitral stenosis

(3) Type I or Type IIIb using the functional classification of Carpentier et al

(4) Mitral regurgitation by echocardiography or ventriculogram with dye injection (graded 1+ to 4+)

(5) Regurgitant jet to the posterior wall of the left atrium without reversal or blunting of pulmonary venous flow.

 

where:

• Carpentier Type I = annular dilatation with normal leaflet motion

• Carpentier Type IIIb = restricted leaflet motion during systole.

• The original definition of Aklog et al for moderate ischemic MR specified grade 3+ MR.

• I added an item to indicate that the MR developed following the onset of ischemic heart disease (to separate it from congenital or other forms of MR).