Effect of mitral regurgitation on diastolic filling with left ventricular hypertrophy

M. Abubakr Shaikh, Steven J. Lavine

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36 Scopus citations

Abstract

Earlier studies have suggested that mitral regurgitation (MR) augments early left ventricular (LV) diastolic filling. To determine whether MR affects early diastolic filling in patients with abnormal diastolic filling, transmitral pulsed-wave Doppler recordings were used to study 32 normal subjects, 21 patients with LV hypertrophy, 23 with LV hypertrophy and MR and 15 patients with MR. Patients with MR had increased peak early filling velocities (MR 108 ± 27 cm/s, normal 80 ± 16 cm/s, p < 0.01), peak atrial filling velocities (MR 72 ± 18 cm/s, normal 55 ± 12 cm/s, p < 0.05) and increased deceleration rates (MR 5.0 ± 1.9 m/s2, normal 3.5 ± 1.2 m/s2, p < 0.05). Patients with LV hypertrophy had reduced peak early filling velocities (69 ± 14 cm/s, p < 0.05) and increased peak atrial filling velocities (83 ± 16 cm/s, p < 0.001). There was also an increase in the atrial filling fraction and reduction in the rapid filling fraction as compared with normal patients. Patients with LV hypertrophy and MR had increased peak early filling velocities (98 ± 26 cm/s, p < 0.01 vs normal, p < 0.001 vs LV hypertrophy patients), increased atrial filling velocities (84 ± 27 cm/s, p < 0.001 vs normal), increased deceleration rates (4.4 ± 2.4 m/s2, p < 0.05 vs normal) and a normal distribution of diastolic filling. Within the LV hypertrophy and MR group, diastolic filling parameters were similar when patients were subgrouped on the basis of auscultability of MR. MR augments early diastolic filling and may tend to normalize diastolic filling patterns in LV hypertrophy patients. The use of diastolic filling to evaluate diastolic function in patients with MR should be used with caution.

Original languageEnglish
Pages (from-to)590-594
Number of pages5
JournalThe American journal of cardiology
Volume61
Issue number8
DOIs
StatePublished - Mar 1 1988

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