A Longitudinal Study of Mitral Regurgitation Detected after Acute Myocardial Infarction

Figures

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  Figure 1. Study flowchart. MI = myocardial infarction; MR = mitral regurgitation; PCI= percutaneous coronary intervention; TTE= transthoracic echocardiography.

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  Figure 2. Changes in MR severity over time. Analyses are based on the n = 230 follow-up TTEs. Trends over time in MR were assessed using three generalized estimating equation models, each of which had a single covariate, indicating the timing of the TTE, relative to the baseline TTE. (A) visualises two of these models, with dependent variables specifying whether each TTE indicated an increase in MR severity, or a reduction in MR severity, respectively, compared to the baseline TTE. For (B) the dependent variable specified whether each TTE indicated moderate-to-severe MR. The resulting models are represented by broken lines. Points represent the observed rates of each outcome within subgroups of n = 46 consecutive TTEs (i.e., quintiles), and are plotted at the mean of the interval; whiskers represent 95% confidence intervals. MR = mitral regurgitation; TTE = transthoracic echocardiography.

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  Figure 3. Associations between age/creatinine clearance and changes in MR severity. Plots are based on binary logistic regression models, with either the age (A) or creatinine clearance (B) as a continuous covariate. Two models were produced for each factor, with the dependent variable being reduction in MR severity (vs. increase or no change) in the first, and increase in MR severity (vs. reduction or no change) in the second. For all models, the changes in MR severity were assessed between the baseline and final TTE for each patient. The two models were then evaluated to estimate the rates of reductions and increases in MR severity for each value of the covariate, with the difference between these assumed to be the rate of “no change”. MI = myocardial infarction; MR = mitral regurgitation; TTE = transthoracic echocardiography.

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  Figure 4. Kaplan–Meier curves of freedom from death/heart failure admission by change in MR severity. (A) groups all patients by the change in MR severity from the baseline TTE to the final follow-up TTE. (B) only includes those patients where the first follow-up TTE was within 1 year of the baseline TTE (n = 77), and groups these by the change in MR severity from baseline to the first follow-up TTE. p-Values are from univariable Cox regression models. HF = heart failure; MI = myocardial infarction; MR = mitral regurgitation; TTE = transthoracic echocardiography.