This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Borgenhagen, D. M. Articles by Sonnenblick, E. H. Search for Related Content PubMed PubMed Citation Articles by Borgenhagen, D. M. Articles by Sonnenblick, E. H.

Circulation, Vol 56, 106-113, Copyright © 1977 by American Heart Association

ARTICLES

The effects of left ventricular load and contractility on mitral regurgitant orifice size and flow in the dog

DM Borgenhagen, JR Serur, R Gorlin, D Adams and EH Sonnenblick

Acute mitral regurgitation (MR) was produced in 12 dogs by closed chest partial valvulectomy and the relative contributions of MR pressure gradient (MRG), the time for regurgitant flow (VSI), and the MR orifice area (MRA) to mitral regurgitant volume (MRV) assessed. Aortic and left atrial pressures, biplane left ventricular (LV) angiography, forward flow and mitral regurgitant flow (MRF) were measured following MR induction and following augmentation of left ventricular end-diastolic volume (EDV), increased aortic resistance (angiotensin), and in the presence of increased ventricular contractility (calcium or epinephrine). Mitral regurgitation orifice area was determined by calculation and the diameters of the mitral anulus and subvalvular areas measured angiographically. Angiotensin and volume infusion induced a substantial increase in MRF which was largely dependent on an increase in MRA but not MRG, while augmentation of contractility decreased MRF accompanied by a decrease in MRA, relatively independent of MRG. Left ventricular size and shape are major determinants of MRA and resultant MRF in acute mitral regurgitation. These findings may help to explain the effects of such factors as ventricular loading and volume on the clinical course of mitral regurgitation in man.

This article has been cited by other articles:

				T. G. Neilan, T.-T. Ton-Nu, Y. Kawase, R. Yoneyama, K. Hoshino, F. del Monte, R. J. Hajjar, M. H. Picard, R. A. Levine, and J. Hung Progressive nature of chronic mitral regurgitation and the role of tissue Doppler-derived indexes Am J Physiol Heart Circ Physiol, May 1, 2008; 294(5): H2106 - H2111. [Abstract] [Full Text] [PDF]

				S. Fukuda, R. Grimm, J.-M. Song, T. Kihara, M. Daimon, D. A. Agler, B. L. Wilkoff, A. Natale, J. D. Thomas, and T. Shiota Electrical Conduction Disturbance Effects on Dynamic Changes of Functional Mitral Regurgitation J. Am. Coll. Cardiol., December 20, 2005; 46(12): 2270 - 2276. [Abstract] [Full Text] [PDF]

				R. Lapu-Bula, A. Robert, D. Van Craeynest, A.-M. D'Hondt, B. L. Gerber, A. Pasquet, J. A. Melin, M. De Kock, and J.-L. Vanoverschelde Contribution of Exercise-Induced Mitral Regurgitation to Exercise Stroke Volume and Exercise Capacity in Patients With Left Ventricular Systolic Dysfunction Circulation, September 10, 2002; 106(11): 1342 - 1348. [Abstract] [Full Text] [PDF]

				M. Enriquez-Sarano, A.-J. Basmadjian, A. Rossi, K. R. Bailey, J. B. Seward, and A. J. Tajik Progression of mitral regurgitation: A prospective Doppler echocardiographic study J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1137 - 1144. [Abstract] [Full Text] [PDF]

				J. Hung, Y. Otsuji, M. D. Handschumacher, E. Schwammenthal, and R. A. Levine Mechanism of dynamic regurgitant orifice area variation in functional mitral regurgitation: Physiologic insights from the proximal flow convergence technique J. Am. Coll. Cardiol., February 1, 1999; 33(2): 538 - 545. [Abstract] [Full Text] [PDF]

				L. B. Rosario, L. W. Stevenson, S. D. Solomon, R. T. Lee, and S. C. Reimold The mechanism of decrease in dynamic mitral regurgitation during heart failure treatment: importance of reduction in the regurgitant orifice size J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1819 - 1824. [Abstract] [Full Text] [PDF]

				K. S. Dujardin, M. Enriquez-Sarano, K. R. Bailey, R. A. Nishimura, J. B. Seward, and A. J. Tajik Grading of Mitral Regurgitation by Quantitative Doppler Echocardiography : Calibration by Left Ventricular Angiography in Routine Clinical Practice Circulation, November 18, 1997; 96(10): 3409 - 3415. [Abstract] [Full Text]

				S. He, A. A. Fontaine, E. Schwammenthal, A. P. Yoganathan, and R. A. Levine Integrated Mechanism for Functional Mitral Regurgitation : Leaflet Restriction Versus Coapting Force: In Vitro Studies Circulation, September 16, 1997; 96(6): 1826 - 1834. [Abstract] [Full Text]

				M. Enriquez-Sarano, L. J. Sinak, A. J. Tajik, K. R. Bailey, and J. B. Seward Changes in Effective Regurgitant Orifice Throughout Systole in Patients With Mitral Valve Prolapse : A Clinical Study Using the Proximal Isovelocity Surface Area Method Circulation, November 15, 1995; 92(10): 2951 - 2958. [Abstract] [Full Text]

				G. L. Pierpont and R. C. Talley Pathophysiology of Valvar Heart Disease: The Dynamic Nature of Mitral Valve Regurgitation Arch Intern Med, May 1, 1982; 142(5): 998 - 1001. [Abstract] [PDF]

				L. Gould, C.V.R. Reddy, S.G. Kim, and K.C. Oh Hemodynamic Effects of Phentolamine in Valvular Abnormalities Angiology, December 1, 1978; 29(12): 898 - 906. [PDF]