Document Detail

Dynamics of mitral regurgitation during nitroglycerin therapy: a Doppler echocardiographic study.
MedLine Citation:
PMID:  3092608     Owner:  NLM     Status:  MEDLINE    
Seven patients with decompensated chronic heart failure and functional mitral regurgitation were studied before and during administration of nitroglycerin at a mean dose of 42 micrograms/min (range 20 to 90 micrograms/min). Forward aortic flow obtained by pulsed Doppler increased significantly from 35 +/- 8 to 45 +/- 9 ml/beat (p less than 0.001) and correlated well with the cardiac output measured by thermodilution technique (r = 0.8). Whereas regurgitant mitral volume calculated from the difference between echocardiographic total stroke volume and forward aortic flow decreased significantly from 19 +/- 9 to 3 +/- 3 ml/beat (p less than 0.001), peak velocity of mitral regurgitant flow increased from 4.1 +/- 0.9 to 4.4 +/- 1.0 m/sec (p less than 0.05). The decrease in effective mitral regurgitation area derived from a modified Gorlin formula average 80%. Accordingly, in patients with decompensated chronic heart failure and functional mitral regurgitation, nitroglycerin decreases mitral regurgitant area substantially, and thus almost abolishes mitral regurgitation despite an increase in systolic pressure gradient between left ventricle and atrium. Moreover, the increase in forward flow can be entirely accounted for by the reduction in mitral regurgitant flow.
G Keren; A Bier; J A Strom; S Laniado; E H Sonnenblick; T H LeJemtel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  112     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1986 Sep 
Date Detail:
Created Date:  1986-09-29     Completed Date:  1986-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  517-25     Citation Subset:  AIM; IM    
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MeSH Terms
Heart Failure / complications,  drug therapy*,  physiopathology
Middle Aged
Mitral Valve Insufficiency / complications,  drug therapy*,  physiopathology
Nitroglycerin / therapeutic use*
Reg. No./Substance:

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