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Diastolic mitral regurgitation, observed in left ventricular angiograms, is linked to post-extrasystolic pauses. This condition arises from increased ventricular filling due to extrasystoles, not coronary anatomy or overall ventricular function.
Area of Science:
- Cardiology
- Cardiac Imaging
- Physiology
Background:
- Diastolic mitral regurgitation is an uncommon finding during left ventricular angiography.
- Its relationship with coronary anatomy and left ventricular function is not well understood.
Purpose of the Study:
- To analyze the occurrence and potential causes of diastolic mitral regurgitation identified via left ventricular angiography.
Main Methods:
- Retrospective analysis of left ventricular angiograms.
- Correlation of diastolic mitral regurgitation findings with coronary anatomy and left ventricular function parameters.
Main Results:
- Diastolic mitral regurgitation was observed in a subset of patients.
- No correlation was found between diastolic mitral regurgitation and coronary artery anatomy.
- No correlation was found between diastolic mitral regurgitation and left ventricular ejection fraction.
- Diastolic mitral regurgitation consistently occurred during post-extrasystolic pauses.
- Contrast material appeared as a 'float' into the atrium, distinct from systolic regurgitation jets.
Conclusions:
- Diastolic mitral regurgitation is associated with post-extrasystolic pauses.
- The mechanism involves increased left ventricular filling after extrasystoles, leading to a reversed pressure gradient and valve regurgitation.
- It is independent of coronary anatomy and global left ventricular function.
Abstract:
An analysis of left ventricular angiograms not seldom revealed a diastolic mitral regurgitation. There was neither a correlation between the diastolic mitral regurgitation and the anatomic situation in the coronary system nor with the left ventricular function. The diastolic regurgitation always occurred in a postextrasystolic pause at the end of the diastole. While the systolic mitral regurgitation produces a jet appearance of contrast material, the diastolic mitral regurgitation is seen as a floating of contrast material into the atrium. The cause of the diastolic mitral regurgitation appears to be an incremented left ventricular filling subsequent to repeated and incoordinately-occurring extrasystoles with diminished systolic ejection which leads to reversal of the pressure gradient between the left atrium and left ventricle and permits regurgitation over the incompletely closed valve.