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Evaluation of left ventricular ejection fraction as a measure of pump performance in patients with chronic mitral regurgitation
Author(s) -
Timmis Steven B.H.,
Kirsh Marvin M.,
Montgomery Daniel G.,
Starling Mark R.
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(200003)49:3<290::aid-ccd14>3.0.co;2-c
Subject(s) - ejection fraction , medicine , cardiology , mitral regurgitation , stroke volume , mitral valve , heart failure
Left ventricular (LV) ejection fraction may not adequately detect a reduction in LV systolic performance resulting from chronic mitral regurgitation (MR), due to ventricular unloading into the low‐impedance left atrium. To determine whether LV ejection fraction sufficiently gauges myocardial function in MR, nine patients were studied using micromanometer‐measured LV pressures and biplane cineventriculography before and 1 year after mitral valve surgery. Six control patients were also studied. LV ejection fraction was normal in MR patients, despite an increase in LV end‐systolic volume index. LV end‐systolic pressure‐volume and stress‐volume ratios in MR patients were lower than in controls ( P < 0.05 and P < 0.01), suggesting that LV systolic performance fell. One year after mitral valve surgery, LV ejection fraction decreased ( P < 0.05) even though LV end‐systolic volume index ( P < 0.05), pressure‐volume ( P < 0.05), and stress‐volume ratios ( P < 0.01) all improved. Thus, LV ejection fraction inadequately reflected LV systolic function in MR patients before and after mitral valve surgery. Cathet. Cardiovasc. Intervent. 49:290–296, 2000. © 2000 Wiley‐Liss, Inc.