This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Keren, G. Articles by Yellin, E. L. Search for Related Content PubMed PubMed Citation Articles by Keren, G. Articles by Yellin, E. L.

Circulation, Vol 74, 684-692, Copyright © 1986 by American Heart Association

ARTICLES

Time variation of mitral regurgitant flow in patients with dilated cardiomyopathy

G Keren, TH LeJemtel, AA Zelcer, JS Meisner, A Bier and EL Yellin

Angiographic results in patients with mitral regurgitation suggest that up to 50% of the regurgitant volume occurs during the preejection period. This contrasts markedly with the electromagnetic measurements of mitral regurgitant flow in anesthetized dogs, which suggest that only 5% of mitral regurgitant flow occurs during the preejection period. Therefore, we used two-dimensional and Doppler echocardiography to quantify mitral regurgitation during aortic ejection and in the preejection and postejection periods in eight patients with severe heart failure. Mitral regurgitant volume (RV) was calculated as the difference between total stroke volume (by two-dimensional echocardiography) and forward aortic flow (by pulsed Doppler). Regurgitant velocity (V) and time (RT) were measured by continuous-wave Doppler, and the mean regurgitant area (RAm) was calculated from the RT and mean regurgitant velocity (Vm): RAm = (RV/RT)/Vm. As a first approximation, the RA was assumed to be constant during systole, and the regurgitant volume during aortic ejection and during the preejection and postejection periods was calculated from: RVi = (Vmi) (RTi) (TAm), where Ti represents the duration of the appropriate period. Percentages of total regurgitant volume occurring during the preejection, ejection, and postejection periods were 13 +/- 4%, 79 +/- 5%, and 8 +/- 5%, respectively. Thus, in contrast to previously reported angiographic studies, mitral regurgitation occurs predominantly during the aortic ejection period. These results were not substantially changed by assuming a 20% reduction in effective regurgitant orifice area between the preejection and ejection periods and are consistent with data from chronically instrumented dogs with mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				L. W. Stevenson, T. H. Le Jemtel, E. U. Alt, L. W. Stevenson, T. H. Le Jemtel, and E. U. Alt Hemodynamic Goals Are Relevant Circulation, February 21, 2006; 113(7): 1020 - 1033. [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]

				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]

				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]