IMR Press / RCM / Volume 24 / Issue 9 / DOI: 10.31083/j.rcm2409256
Open Access Original Research
Wall Motion Score Index Predicts Persistent Moderate or Severe Secondary Mitral Regurgitation and its Prognostic Role in Patients Undergoing Percutaneous Coronary Intervention
Linfang Qiao1,2,3,†Haozhang Huang1,2,3,†Jiulin Liu1,2,3,†Congzhuo Jia2,3,†Yibo He2,3Sijia Yu1,2,3Hongyu Lu2,3Ziyou Zhou2,3,4Tian Chang2,3,4Shiqun Chen2,3Ning Tan1,2,3Jin Liu2,3,*Yong Liu1,2,3,*Jiyan Chen1,2,3,*
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1 The Second School of Clinical Medicine, Southern Medical University, 510515 Guangzhou, Guangdong, China
2 Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
3 Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China
4 Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, 510100 Guangzhou, Guangdong, China
*Correspondence: (Jin Liu); (Yong Liu); (Jiyan Chen)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(9), 256;
Submitted: 14 November 2022 | Revised: 4 March 2023 | Accepted: 13 March 2023 | Published: 18 September 2023
(This article belongs to the Special Issue Clinical Updates in Management of Mitral and Tricuspid Valve Disease)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Patients with secondary mitral regurgitation (sMR) often present with greater mortality and comorbidity, which may be predicted by some risk factors. This study was designed to investigate the prognostic meaning of the echocardiographically detected wall motion score index (WMSI) in coronary artery disease (CAD) patients with moderate or severe baseline sMR who underwent percutaneous coronary intervention (PCI) therapy. Methods: The present study was a multi-center and prospective cohort of consecutive CAD patients with baseline moderate or severe sMR who underwent PCI. All underwent echocardiography at baseline and at follow-up after PCI to assess sMR and WMSI. The primary endpoint was the persistence of moderate or severe sMR after the second echocardiographic measurement. Logistic and Cox proportional hazards models were constructed for the primary (persistent moderate or severe sMR) and secondary (worsening heart failure [HF]; all-cause mortality; cardiovascular-specific mortality; and major adverse cardiovascular events [MACE]) endpoints. Results: Among 920 participants, 483 had WMSI values of 1.47, and 437 were less. Of all the participants, 366 (39.8%) continued to have moderate or severe sMR after the second echocardiogram measurement. After full adjustment for confounders, elevated WMSI after PCI was independently associated with the primary endpoint during 3–12 month follow-up. Similarly, elevated WMSI was associated with increased risk of worsening HF, all-cause mortality, cardiovascular-specific mortality, and MACE. Conclusions: Persistent moderate or severe sMR is common (approximately 40%) in PCI patients. Elevated WMSI in CAD patients after PCI is a predictor of persistent moderate or severe sMR and has independent negative prognostic value. Patients with CAD and sMR should be monitored for WMSI to identify those at higher risk of mortality and comorbidity.

persistent mitral regurgitation
coronary artery disease
percutaneous coronary intervention
wall motion score index
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2020B1111170011/Guangdong Provincial science and technology project
KJ022021049/Guangdong Provincial science and technology project
82070360/The National Science Foundation for Young Scientist of China
Fig. 1.
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