Assessment of late-diastolic mitral regurgitation associated with aortic regurgitation:Pulsed Doppler echocardiographic study Jun'ichi Sanada 1 , Masazumi Kawahira 1 , Hiromichi Kubo 1 , Kousuke Mawatari 1 , Nobuchika Kuroiwa 1 , Kazuhiko Nakamura 1 , Shuji Hashimoto 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University pp.163-169
Published Date 1986/2/15
DOI https://doi.org/10.11477/mf.1404204820
  • Abstract
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In aortic regurgitation, the existence of late-dias-tolic mitral regurgitation (LDMR) has been point-ed out by some investigators, indicating the possi-bility of overestimation for systolic mitral regurgi-tation on left ventriculography. The pathophysiolog-ical significance of this flow, however, has been less analyzed because of the methodological limi-tation. In this study, LDMR was assessed by using pulsed Doppler echocardiography in 29 cases with aortic regurgitation that were performed cardiac catheterization.

LDMR was observed in 10 of 14 cases with at-rial fibrillation at the cardiac cycle in which R-R interval showed prolongation, and in one of 15 cases with sinus rhythm. In 7 of 11 cases with LDMR, its existence was also clarified by left ventriculography. Moreover, in 3 of 11 cases in which left ventricular and pulmonary arterial wedge pressure was recorded simultaneously, late-diastolic reversal of the pressure gradient was observed, indicating the occurrence of the reversal of atrio-ventricular pressure gradient. Although mitral valve diseases were observed in 8 of these 11 cases, the other 3 cases had normal mitral valve. These results suggested that both the existence of premature mitral valve closure that was caused by the delay of following left ventricular contraction owing to R-R interval prolongation, and the appearance of the reversal of left atrial-left ventri-cular pressure gradient that was induced by left ventricular overfilling, had the important role for the occurrence of LDMR. On the other hand, on phonocardiography, apical late diastolic murmur was observed at the cardiac cycle in which R-R interval was prolonged, that was believed to be caused by LDMR.

In conclusion, pulsed Doppler echocardiography is useful for assessing LDMR in aortic regurgita-tion, and in relieving overestimation of systolic mit-ral regurgitation on left ventriculography that is induced by LDMR because phasic analysis can be accomplished easily by using this method.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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