Document Detail

Atrial contribution to ventricular filling in mitral stenosis.
MedLine Citation:
PMID:  1914089     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The importance of the contribution of atrial systole to ventricular filling in mitral stenosis is controversial. The cause of reduced cardiac output following the onset of atrial fibrillation may be due to an increased heart rate, a loss of booster pump function, or both. METHODS AND RESULTS: We studied the atrial contribution to filling under a variety of conditions by combining noninvasive studies of patients with computer modeling. Thirty patients in sinus rhythm with mild-to-severe stenosis were studied with two-dimensional and Doppler echocardiography for measurement of mitral flow velocity and mitral valve area (MVA). The mean +/- SD atrial contribution to left ventricular filling volume was 18 +/- 10% and varied inversely with mitral resistance. Patients with mild mitral stenosis (MVA, 1.8 +/- 0.7 cm2) and severe mitral stenosis (MVA, 0.9 +/- 0.2 cm2) had atrial contributions of 29 +/- 4% and 9 +/- 5%, respectively. The pathophysiological mechanisms responsible for these trends were further investigated by the computer model. In modeled severe mitral stenosis, increasing heart rate from 75 to 150 beats/min caused an increase of 5.2 mm Hg in mean left atrial pressure, whereas loss of atrial contraction at a heart rate of 150 beats/min caused only a 1.3 mm Hg increase. CONCLUSIONS: The atrial booster pump contributes less to ventricular filling in mitral stenosis than in the normal heart, and the loss of atrial pump function is less important than the effect of increasing heart rate as the cause of decompensation during atrial fibrillation.
J S Meisner; G Keren; O E Pajaro; A Mani; J A Strom; R W Frater; S Laniado; E L Yellin
Related Documents :
21297129 - Myocardial ischaemia and viability: the pivotal role of echocardiography.
18368289 - Leukocytoclastic vasculitis with severe cardiac involvement in an infant: a case report.
860679 - Mitral valve prolapse with atrioventricular and sinoatrial node abnormalities of long d...
6887669 - Kay's mitral valve repair for mitral regurgitation due to ruptured chordae tendineae--c...
20369509 - Malpositioned mechanical mitral valves causing left ventricular outflow tract obstruction.
11986599 - Randomized trial comparing partial versus complete chordal-sparing mitral valve replace...
9779029 - Management of acute coronary syndromes with low molecular weight heparin: timi 11a and ...
10843159 - Effect of thyroid hormones on cardiac function, geometry, and oxidative metabolism asse...
19026129 - Acute myocardial infarction due to sinus of valsalva aneurysm in a patient with behçet...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  84     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1991 Oct 
Date Detail:
Created Date:  1991-11-01     Completed Date:  1991-11-01     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1469-80     Citation Subset:  AIM; IM    
Department of Cardiothoracic Surgery, Albert Einstein College of Medicine, Bronx, NY 10461.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Atrial Fibrillation / physiopathology
Atrial Function / physiology*
Computer Simulation*
Heart Rate / physiology
Middle Aged
Mitral Valve Stenosis / physiopathology*,  ultrasonography
Models, Cardiovascular*
Myocardial Contraction / physiology
Ventricular Function / physiology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Mitozantrone and prednimustine in the treatment of advanced breast cancer--a toxic regimen with low ...
Next Document:  A new method for quantitation of mitral regurgitation based on color flow Doppler imaging of flow co...