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Pressure-flow relations across the normal mitral valve.

I A Jawad, M H Ghali, R L Brown

    The American Journal of Cardiology
    |April 1, 1987
    PubMed
    Summary
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    In healthy individuals, the relationship between transmitral pressure gradient and flow rate is linear. This pressure-flow relation is independent of the mitral valve area under normal physiological conditions.

    Area of Science:

    • Cardiovascular Physiology
    • Cardiac Hemodynamics
    • Valvular Heart Disease

    Background:

    • The mitral valve area significantly influences the atrioventricular pressure-flow relationship in stenosis.
    • The pressure-flow relation is typically linear without obstruction.
    • The impact of a normal mitral valve area on this relationship remains unexamined.

    Purpose of the Study:

    • To investigate the pressure-flow relationship across a normal mitral valve.
    • To determine if mitral valve area affects the linearity of the pressure-flow relation in healthy individuals.

    Main Methods:

    • Simultaneous pulsed Doppler transmitral flow and thermodilution cardiac output measurements in 25 patients.
    • Calculation of mean flow rate using stroke volume and diastolic filling period.

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  • Estimation of instantaneous and mean pressure gradients using the modified Bernoulli equation.

    • Main Results:

    • An excellent linear correlation (r = 0.91) was observed between mean flow rate and mean pressure gradient.
    • Average mean flow rate was 223 +/- 70 ml/s and mean pressure gradient was 1.4 +/- 0.8 mm Hg.
    • The linear relationship held true without accounting for individual variations in mitral valve area.

    Conclusions:

    • Confirms a linear relationship between mean pressure gradient and mean flow rate in the absence of mitral valve obstruction.
    • Suggests that this linear pressure-flow relationship is independent of mitral valve area under normal physiological conditions.