Open AccessDiastolic atrioventricular valve closure and regurgitation following atrial contraction: Their relation to timing of atrial contraction
Author(s) -
Okamoto M.,
Tsubokura T.,
Kajiyama G.,
Miyatake K.,
Kinoshita N.,
Sakakibara H.,
Nimura Y.
Publication year - 1989
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960120307
Subject(s) - medicine , cardiology , diastole , contraction (grammar) , atrioventricular valve , mitral valve , regurgitation (circulation) , atrioventricular block , doppler echocardiography , blood pressure , ventricle
Abstract Some authors have proposed that atrial contraction per se is able to close the atrioventricular (AV) valves. To determine whether tight closure of the AV valves can be accomplished solely by atrial contraction, the existence of diastolic regurgitation following atrial contraction and its relation to the PQ interval were examined in 13 patients with AV block (2 of the first degree, 4 of the second degree, and 7 of the third degree), using pulsed Doppler echocardiography, which allowed noninvasive estimation of valvular regurgitation in the physiological state. Diastolic mitral and tricuspid regurgitations were detected in the left and right atria near the respective AV valves in all 13 patients despite different degrees of AV block, while these valves were observed to be in an apparently closed position during regurgitation on the two‐dimensional and M‐mode echocardiograms. The duration of regurgitant signals was prolonged with an increase in the PQ interval in the electrocardiogram, but it became short again as the P wave approached the preceding rapid filling wave. These results suggest that atrial contraction may initiate the closure of the AV valves but is not capable of closing the valves tightly, and atrial contraction with long PQ interval may contribute little to augmentation of cardiac output in patients with AV block.