Effect of exercise on left ventricular ejection time in patients with prolapsing mitral leaflet syndrome

The effect of exercise on left ventricular ejection time was determined in 12 subjects with prolapsing mitral valve leaflet syndrome (PML). A single lead ECG (CM5), phonocardiogram and carotid pulse contour were recorded simultaneously with the subjects at supine rest before and immediately after multistage treadmill exercise. Systolic time intervals were measured from five consecutive complexes to determine the pre-ejection period (PEP), left ventricular ejection time (LVET) and total electromechanical systole (QS2). LVET was corrected for heart rate and defines as LVETc. In nine subjects, an increase of 1 to 49 msec was observed in the LVETc following exercise. A shorter resting LVETc and greater afterload at peak exercise was related to an increase in LVETc of 10 msec or more. Exercise elicited or evoked evidence of left ventricular dysfunction. The results support the concept that impaired left ventricular performance is a concomitant of this syndrome.