{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:59:56Z","timestamp":1768456796250,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T00:00:00Z","timestamp":1560729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Severe mitral regurgitation (<jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content>) can occur following myocardial infarction (<jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>) with either partial or complete papillary muscle rupture (<jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content>). Although the incidence of this complication has significantly decreased, it is still associated with significant mortality. We sought to evaluate the different echocardiographic and clinical presentations of <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A review of all the urgent procedures for ischemic <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content> between January 2000 and June 2016 was performed to identify patients who underwent surgery for <jats:styled-content style=\"fixed-case\">PMR<\/jats:styled-content>. Surgical protocols and echocardiographic studies were used to identify patients with <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content>. A total of 37 patients had cardiac surgery for <jats:styled-content style=\"fixed-case\">PMR<\/jats:styled-content> (18 <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content>, 19 <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content>). All patients with <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content> were in cardiogenic shock at the time of diagnosis, as opposed to only 53% of patients with <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0008). Between the time of diagnosis and surgery, 7 patients with <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> developed cardiogenic shock. Transthoracic echocardiography (<jats:styled-content style=\"fixed-case\">TTE<\/jats:styled-content>) led to the diagnosis in 72% of <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content> and 32% of <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). <jats:styled-content style=\"fixed-case\">TEE<\/jats:styled-content> had a yield of 100% for both <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content>. Six pathologic varieties of post\u2010<jats:styled-content style=\"fixed-case\">MI PMR<\/jats:styled-content> were recognized on echocardiography and during surgery. Early postoperative, 1 (72% vs 84%), 3 (67% vs 84%), and 5\u00a0years (67% vs 74%) survival rates were similar for <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.26).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Partial <jats:styled-content style=\"fixed-case\">PMR<\/jats:styled-content> is associated with a different clinical and echocardiographic presentation than <jats:styled-content style=\"fixed-case\">cPMR<\/jats:styled-content>. Still, most <jats:styled-content style=\"fixed-case\">pPMR<\/jats:styled-content> patients progress toward cardiogenic shock. Prompt diagnosis and referral for surgery are critical and could potentially decrease mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14402","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T06:43:18Z","timestamp":1560840198000},"page":"1322-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical and echocardiographic presentation of postmyocardial infarction papillary muscle rupture"],"prefix":"10.1111","volume":"36","author":[{"given":"\u00c9milie","family":"Leroux","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Laval University Quebec City Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Chauvette","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Laval University Quebec City Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Voisine","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Laval University Quebec City Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Dagenais","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Laval University Quebec City Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9ric","family":"Charbonneau","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Laval University Quebec City Quebec 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