Introduction: Ischemic mitral regurgitation (MR) occurs frequently in patients with coronary artery disease (CAD) and is associated with an increased long-term risk (1). Moderate to severe MR is reported in 10-20% of patients with ischemic heart disease. Even mild MR in patients with ischemic heart disease is an independent predictor of adverse events, heart failure and mortality (2). The mechanism of ischemic MR is complex and consequence of a decompensating ventricle, not an intrinsic disease of the valve. Ischemic MR may be due to alterations in left ventricular geometry, distortion and enlargement of the mitral annulus or/and dyssynchrony of ventricular contraction which can cause disturbance of normal valve closure (3). The most important changes in ventricular geometry occur with infarction (4).

Results: We included 686 patients with mitral regurgitation, 50% had CAD. Gender distribution showed that CAD is more frequent in men than women (62 vs 35%). One vessel disease was present in 34% of patients, while 27% of them had two-, and 39% had three vessel disease. According the MR severity, 62% of patients with CAD had mild MR, 30% moderate, and 8% severe MR. Among patients with severe MR, 41% had one-, 13% two-, and 45% had three vessel disease. Most of women had one vessel disease (47%), while men predominantly had three vessel disease (44%).

Conclusion: The management is largely focused on medical therapy, and for those eligible, coronary revascularization or cardiac resynchronization therapy. It is extremely important to evaluate patients with non-invasive and invasive diagnostic procedures to find out who may have benefit from revascularization or valve repair only or both.