Document Detail


Effect of cardiac output on mitral valve area in patients with mitral stenosis: validation and pitfalls of the pressure half-time method.
MedLine Citation:
PMID:  11206768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: The non-invasive evaluation of mitral valve area is often used in the assessment of patients with mitral stenosis. The pressure half-time method is commonly used to calculate valve area, but is inaccurate in many clinical scenarios. We sought to quantify the effects of changing cardiac output on the accuracy of mitral valve area determination. METHODS: Thirteen patients with mitral stenosis underwent routine stress echocardiography with resting and peak exercise results compared. A previously described and clinically validated mathematical model of the cardiovascular system was used to validate the clinical results. Seven different loading conditions for each of four different stenotic valve areas were modeled. RESULTS: In patients, with increasing cardiac output, pressure half-time decreased (-30.6+/-35.3 ms/l/min) and calculated valve area increased by 0.25+/-0.30 cm2/l/min. By continuity, it appeared that approximately half of this increase was due to actual valve orifice stretching, the remainder reflecting fundamental changes in the relationship between half-time and valve area. Mathematical modeling resulted in similar changes in pressure half-time and calculated valve area (0.06 to 0.12 cm2/l/min, p = 0.20 versus clinical results). CONCLUSION: Changes in cardiac output result in predictable changes in pressure half-time, and should be considered when performing serial examinations in patients with mitral stenosis.
Authors:
M S Firstenberg; D L Prior; N L Greenberg; S Wahi; A Pasquet; M J Garcia; J D Thomas
Related Documents :
8923988 - Experimental analysis of fluid mechanical energy losses in aortic valve stenosis: impor...
19727008 - Synergistic effect of mitral expression of tissue inhibitor of metalloproteinase-2 with...
16153508 - Pulmonary regurgitation end-diastolic gradient is a doppler marker of cardiac status: d...
10367468 - Staffieri tracheo-oesophageal prosthesis for voice rehabilitation after laryngectomy: a...
7491088 - Vascular alpha-1 adrenergic receptor subtypes in the regulation of arterial pressure.
24572178 - Optimal care and design of the tracheal cuff in the critically ill patient.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  10     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-02-05     Completed Date:  2001-04-26     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  49-56     Citation Subset:  IM    
Affiliation:
Cardiovascular Imaging Center in the Department of Cardiology, The Cleveland Clinic Foundation, Ohio 44195, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure / physiology*
Cardiac Output / physiology*
Computer Simulation
Diastole / physiology
Echocardiography*
Echocardiography, Doppler
Exercise Test*
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Mitral Valve / physiopathology,  ultrasonography*
Mitral Valve Stenosis / physiopathology,  ultrasonography*
Models, Theoretical
Stroke Volume / physiology
Systole / physiology
Ventricular Function, Left / physiology
Grant Support
ID/Acronym/Agency:
1R01HL56688-01A1/HL/NHLBI NIH HHS

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


Previous Document:  Left ventricular remodeling after pulmonary autograft replacement of the aortic valve (Ross operatio...
Next Document:  Relationship between papillary muscle size and benefit to cardiac function in mitral valve replaceme...