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 Zile, M. R. Articles by Carabello, B. A. Search for Related Content PubMed PubMed Citation Articles by Zile, M. R. Articles by Carabello, B. A.

Circulation, Vol 87, 1378-1388, Copyright © 1993 by American Heart Association

ARTICLES

Changes in diastolic function during development and correction of chronic LV volume overload produced by mitral regurgitation

MR Zile, M Tomita, K Ishihara, K Nakano, J Lindroth, F Spinale, M Swindle and BA Carabello
Gazes Cardiac Research Institute, Department of Medicine, Medical University of South Carolina, Charleston 29425.

BACKGROUND. Mitral regurgitation (MR) causes an augmentation in left ventricular (LV) diastolic function, increasing early diastolic filling rate and decreasing LV stiffness. Whether these changes in diastolic function persist, return to normal, or become abnormal after mitral valve replacement (MVR) is unknown. METHODS AND RESULTS. Simultaneous LV echocardiography and catheterization studies were performed in six dogs in the baseline state (baseline), 3 months after creation of MR (chronic MR), and 3 months after MVR. Chronic MR caused LV dilation (end-diastolic dimension increased from 4.5 +/- 0.1 cm in baseline to 5.8 +/- 0.1 cm in chronic MR, p < 0.05) and eccentric LV hypertrophy (LV-to-body weight ratio increased from 3.6 +/- 0.2 g/kg in baseline to 4.9 +/- 0.4 g/kg in chronic MR, p < 0.05). Chronic MR caused an increase in LV early diastolic filling rate (peak rate of increase in minor-axis dimension increased from 11 +/- 1 cm/sec in baseline to 18 +/- 1 cm/sec in chronic MR, p < 0.05), did not change the time constant of myocardial relaxation (tau was 31 +/- 4 msec in baseline and 30 +/- 2 msec in chronic MR), and caused a decrease in the modulus of regional chamber stiffness from 7.7 +/- 1.2 in baseline to 2.4 +/- 0.03 in chronic MR, p < 0.05. MVR caused the resolution of LV dilation (end- diastolic dimension returned to normal [4.8 +/- 0.2 cm]), but three months after MVR, regression of LV hypertrophy was incomplete (LV-to- body weight ratio remained elevated [4.4 +/- 0.5 g/kg]). After MVR, LV early diastolic filling rate (8 +/- 1 cm/sec), the relaxation time constant (31 +/- 2 msec), chamber stiffness (7.1 +/- 1.8), myocardial stiffness (11.2 +/- 3.1), and LV end-diastolic pressure (8 +/- 1 mm Hg) returned to normal. CONCLUSIONS. The enhanced diastolic function seen in chronic MR returned to normal after correction of the chronic volume overload by MVR.

This article has been cited by other articles:

				W. H. Gaasch and T. E. Meyer Left Ventricular Response to Mitral Regurgitation: Implications for Management Circulation, November 25, 2008; 118(22): 2298 - 2303. [Full Text] [PDF]

				P. Sorajja, R. A. Nishimura, S. R. Ommen, C. S. Rihal, B. J. Gersh, and D. R. Holmes Jr Effect of Septal Ablation on Myocardial Relaxation and Left Atrial Pressure in Hypertrophic Cardiomyopathy: An Invasive Hemodynamic Study J. Am. Coll. Cardiol. Intv., October 1, 2008; 1(5): 552 - 560. [Abstract] [Full Text] [PDF]

				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]

				T. A. Dorfman, B. D. Rosen, M. A. Perhonen, T. Tillery, R. McColl, R. M. Peshock, and B. D. Levine Diastolic suction is impaired by bed rest: MRI tagging studies of diastolic untwisting J Appl Physiol, April 1, 2008; 104(4): 1037 - 1044. [Abstract] [Full Text] [PDF]

				J. I. Fann, N. B. Ingels Jr., and D. C. Miller Pathophysiology of Mitral Valve Disease Card. Surg. Adult, January 1, 2008; 3(2008): 973 - 1012. [Full Text]

				T. A. Dorfman, B. D. Levine, T. Tillery, R. M. Peshock, J. L. Hastings, S. M. Schneider, B. R. Macias, G. Biolo, and A. R. Hargens Cardiac atrophy in women following bed rest J Appl Physiol, July 1, 2007; 103(1): 8 - 16. [Abstract] [Full Text] [PDF]

				M. V. Pancheva, V. S. Panchev, A. V. Suvandjieva, and B. D. Levine Lower body negative pressure vs. lower body positive pressure to prevent cardiac atrophy after bed rest and spaceflight. What caused the controversy? J Appl Physiol, March 1, 2006; 100(3): 1090 - 1090. [Abstract] [Full Text] [PDF]

				G. Cioffi, L. Tarantini, S. De Feo, G. Pulignano, D. Del Sindaco, C. Stefenelli, A. Di Lenarda, and C. Opasich Functional mitral regurgitation predicts 1-year mortality in elderly patients with systolic chronic heart failure Eur J Heart Fail, December 1, 2005; 7(7): 1112 - 1117. [Abstract] [Full Text] [PDF]

				M. H. Yacoub and L. H. Cohn Novel Approaches to Cardiac Valve Repair: From Structure to Function: Part I Circulation, March 2, 2004; 109(8): 942 - 950. [Full Text] [PDF]

				J. I. Fann, N. B. Ingels Jr., and D. C. Miller Pathophysiology of Mitral Valve Disease Card. Surg. Adult, January 1, 2003; 2(2003): 901 - 931. [Full Text]

				J. D. Stroud, C. F. Baicu, M. A. Barnes, F. G. Spinale, and M. R. Zile Viscoelastic properties of pressure overload hypertrophied myocardium: effect of serine protease treatment Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2324 - H2335. [Abstract] [Full Text] [PDF]

				M. A. Perhonen, F. Franco, L. D. Lane, J. C. Buckey, C. G. Blomqvist, J. E. Zerwekh, R. M. Peshock, P. T. Weatherall, and B. D. Levine Cardiac atrophy after bed rest and spaceflight J Appl Physiol, August 1, 2001; 91(2): 645 - 653. [Abstract] [Full Text] [PDF]

				M. R. Zile, M. K. Cowles, J. M. Buckley, K. Richardson, B. A. Cowles, C. F. Baicu, G. Cooper IV, and V. Gharpuray Gel stretch method: a new method to measure constitutive properties of cardiac muscle cells Am J Physiol Heart Circ Physiol, June 1, 1998; 274(6): H2188 - H2202. [Abstract] [Full Text] [PDF]

				B. D. Levine, J. H. Zuckerman, and J. A. Pawelczyk Cardiac Atrophy After Bed-Rest Deconditioning : A Nonneural Mechanism for Orthostatic Intolerance Circulation, July 15, 1997; 96(2): 517 - 525. [Abstract] [Full Text]

				A. L. Chancey, G. L. Brower, J. T. Peterson, and J. S. Janicki Effects of Matrix Metalloproteinase Inhibition on Ventricular Remodeling Due to Volume Overload Circulation, April 23, 2002; 105(16): 1983 - 1988. [Abstract] [Full Text] [PDF]