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Related Experiment Videos

Left ventricular function in subacute and chronic mitral regurgitation. Effect on function early postoperatively.

G J Kontos1, H V Schaff, B J Gersh

  • 1Section of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, Minn. 55905.

The Journal of Thoracic and Cardiovascular Surgery
|August 1, 1989
PubMed
Summary

Patients with subacute mitral regurgitation show increased early systolic wall stress, indicating partial adaptation before symptoms. Ventricular performance indices did not predict surgical outcomes.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Mitral regurgitation (MR) leads to left ventricular (LV) volume overload.
  • The adaptive response of the LV to MR is not fully understood, especially in the subacute phase.

Purpose of the Study:

  • To quantitatively assess LV systolic performance in patients with subacute and chronic mitral regurgitation.
  • To compare LV adaptation and wall stress development between subacute and chronic MR.
  • To determine if preoperative LV function predicts postoperative outcomes.

Main Methods:

  • Quantitative analysis of biplane ventriculograms.
  • Calculation of end-systolic pressure/volume ratio (ESP/VR) to define LV systolic performance.
  • Inclusion of normal subjects, patients with subacute MR (<6 months), and chronic MR (>6 months).

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Main Results:

  • LV volume, mass, and systolic function were similar in subacute and chronic MR groups.
  • Increased rate of LV wall stress development in early systole was observed in subacute MR compared to chronic MR and normal subjects.
  • Symptom duration did not correlate with the degree of LV adaptation.
  • End-systolic LV performance indices did not predict early postoperative clinical response.

Conclusions:

  • Some patients with recent-onset nonischemic MR exhibit partial LV adaptation prior to symptomatic presentation.
  • Early systolic wall stress dynamics differ between subacute and chronic MR.
  • Preoperative LV systolic indices are not reliable predictors of surgical outcomes in MR patients.