Nishino S, Watanabe N, Gi T, et al. - Researchers employed 2- and 3-dimensional transthoracic echocardiography to serially assess mitral valve (MV) remodeling in patients with anterior and inferior acute myocardial infarction (MI). They also evaluated the leaflet pathology by performing additional histopathologic examinations. They analyzed 60 consecutive first-onset acute MI (anterior MI, n = 30; inferior MI, n = 30) patients who had a successful primary percutaneous coronary intervention. These patients were examined prior to primary percutaneous coronary intervention, at 6-month follow-up, and at follow-up 1 year or later following onset. Follow-up revealed that MV area as well as thickness incrementally increased. In patients with persistent ischemic mitral regurgitation (MR) vs those without significant ischemic MR, findings revealed the presence of larger annuls, larger tenting, and a decreased leaflet area/annular ratio with smaller coaptation index. Findings showed that post-MI, there was progression of MV leaflet remodeling both in area and thickness. This study represents the first clinical investigation to document the longitudinal course of MV leaflet remodeling using serial echocardiography.