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Assessment of diastolic mitral regurgitation in complete A-V block:Pulsed Doppler echocardiographic study Jun-ichi Sanada 1 , Kazuhiko Nakamura 1 , Masazumi Kawahira 1 , Shuji Hashimoto 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University pp.943-948
Published Date 1984/9/15
DOI https://doi.org/10.11477/mf.1404204514
  • Abstract
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In order to visualize the patho-physiological significance of diastolic mitral regurgitation in the cases with complete A-V block, 10 cases with complete A-V block and without apparent organic heart diseases were studied using pulsed Doppler echocardiography. All of them showed disturbed mitral regurgitant flow at the left atrial outflow tract, immediately after the laminar flow caused by left atrial contraction. Mitral regurgitant flow disap-peared at the C-point of M-mode echocardiogram suggesting that mitral valve closure was completed by left ventricular isovolumic contraction. Thus, isovolumic contraction flow, that occurred simul-taneously with the strain of chorda tendinea and the change of left ventricular shape, and made a revolution in the left ventricular cavity, was believed to contribute to mitral valve closure mechanism.

On the other hand, in the 3 of 10 cases, it appeared that the longer the preceding P-Q interval, the shorter the Q-IIA interval and the duration of left ventricular ejection flow. Moreover, in one of these 3 cases, apparent II-sound splitting was observed at the cardiac cycle in which IIA occurred earlier. In the other 2 cases, II-sound splitting was obscure because early occurrence of IIP was shown in the same manner as IIA. These observations were inter-preted to indicate the fact that diastolic mitral regurgitation was one of the cause of early occur-rence of IIA, and may result in II-sound splitting in the cases with complete A-V block.


Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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