The indication of adjunctive mitral valve surgery in patients with ischaemic mitral regurgitation (MR) undergoing coronary artery bypass grafting remains controversial.¹ Furthermore, no approach currently predicts in which patients ischaemic MR will resolve with revascularisation alone. It has been recently suggested that a reduction in ischaemic MR caused by an improvement in regional left ventricular (LV) contractility during low dose dobutamine stress echocardiography (LDSE) might predict a beneficial effect of revascularisation on ischaemic MR.¹ This study tested the hypothesis that LDSE induced changes in ischaemic MR are associated with changes in regional LV contractility.

METHODS

Fifteen consecutive patients with stable coronary artery disease, ischaemic LV dysfunction, ejection fraction (EF) < 50%, and at least moderate MR (regurgitant fraction (RF) ⩾ 30%) were selected for enrolment from all patients that had a resting echocardiogram. Exclusion criteria included the following: technically inadequate echocardiogram, structurally abnormal mitral valve, more than trace aortic regurgitation, and non-sinus rhythm. The mean (SD) age of the 15 patients was 68 (8) years; 10 were male and 11 had a prior myocardial infarction. The site of the infarction was anterior in five patients, lateral in one patient, inferoposterior in one patient, both anterior and lateral in one patient, and both anterior and inferoposterior in …