Influence of sequence of atrial and ventricular systoles on closure of mitral valve.

Williams, J. C.; O'Donovan, T P; Cronin, Laura; Wood, Earl H.

doi:10.1152/jappl.1967.22.4.786

Cited by 22 publications

(7 citation statements)

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“…The authors do not mention that the decrease in stroke volume seemed to be independent of heart rate but discuss these data in terms of the per cent change in stroke volume. However, their data support our findings that the absolute change in (18).…”

Section: Discussionsupporting

confidence: 88%

Pressure-flow studies in man: effect of atrial systole on left ventricular function

Ruskin¹,

McHale²,

Harley³

et al. 1970

J. Clin. Invest.

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A B S T R A C T In order to evaluate the effects of atrial contraction on left ventricular function, the pressure gradient technique was used to measure instantaneous aortic blood flow and pressure in nine patients, six having complete heart block and three having normal sinus rhythm. From these data both left ventricular stroke volume and stroke work were calculated. Ventricular rate was controlled by transvenous right ventricular pacing over a range of 50-158 beats/min. At each heart rate, beats which were not preceded by a P wave served as controls. The other beats were divided into six groups according to the duration of the preceding PR interval. The results indicated that stroke volume and stroke work were always affected similarly. In one patient the presence of a P wave did not alter the subsequent stroke volume significantly. In the other patients, beats preceded by P waves had stroke volumes greater than the controls. In general, there was no difference in stroke volume for beats preceded by a P wave having a PR interval within the range of 0.05-0.20 sec. As the PR interval lengthened beyond 0.20 sec stroke volume tended to decrease, especially at more rapid heart rates. The absolute increase in stroke volume after a beat preceded by a P wave (PR interval 0.05-0.20 sec) was quite variable among the patients. For a given patient the absolute increase in stroke volume was essentially independent of heart rate. The percentage change in stroke volume, however, was always greater as the heart rate increased.

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Section: Discussionsupporting

confidence: 88%

Pressure-flow studies in man: effect of atrial systole on left ventricular function

Ruskin¹,

McHale²,

Harley³

et al. 1970

J. Clin. Invest.

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show abstract

“…On the other hand, the finding that incompetence was not produced by isolated ventricular extrasystoles adds further weight to indicator-dilution studies establishing efficacy of ventricle-induced mitral valve closure during atrial fibrillation as reported by Conn and co-workers (10) (using radioisotopes) and by Wood and associates (using indocyanine green and also densitometer analysis of video-tape angiograms in dogs [11,13]), and the confirmation of these findings by Braunwald (14) from analysis of angiograms Circulation Research, Vol. XXII, Jtnturry 1968 in humans.…”

Section: Commentmentioning

confidence: 53%

“…rhythm, that is, when there is no or only an ill-timed atrial contraction, ventricular systole would still seem to be capable of closing the mitral valve efficiently (11). However, if the vigor of ventricular contraction is impaired, ventriculogenic valve closure may be incompetent, and this incompetence may then cease or be greatly relieved if an associated and suitably timed atrial systole is introduced (13).…”

Section: Atriogenic Mitral Valve Refluxmentioning

confidence: 99%

“…However, observations by Conn and associates (10), and by Williams and associates (11), designed for direct measurement of retrograde movement of labeled blood from the left ventricle to the atrium, during cardiac rhythms which excluded a possible contribution to valve closure from atrial contraction, indicated that the ventricle closed the mitral valve with little or no incompetence. Not only did these investigations indicate that atrial systole was unnecessary for effective valve closure, but Hawthorne's investigation (12) suggested that atrially induced valve closure might itself be associated with regurgitation of blood into the atria.…”

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confidence: 99%

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Atriogenic Mitral Valve Reflux: Diastolic Mitral Incompetence Following Isolated Atrial Systoles

Williams

O'Donovan

Vandenberg

et al. 1968

Circulation Research

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Cardiac and aortic pressures were recorded after stellate gangliooectomy and vagotomy. Acute heart block was produced by injecting the atrioventricular node, and atrial and ventricular systoles were controlled electronically to occur independently or in any desired relationship. Angiocardiograms recorded on video tape after injections of 4 ml 69% Renovist into the left ventricle were analyzed with a videodensitometer able to detect small refluxes of contrast medium into the left atrium and correlate them with phases of the cardiac cycle. When ventricular driving was temporarily suspended but atrial driving continued, pressure records indicated mitral valve closure after each atrial systole, but reflux of contrast medium into the atrium occurred after each systole not followed by a normally sequenced ventricular systole. Driving with a 2 : 1 atrioventricular stimulation resulted in reflux, with the alternate atrial contraction dissociated from ventricular systole. Thus, the mitral valve was not effectively closed by atrial systoles that were not followed by normally sequenced ventricular systoles.

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“…The terms trace, minimal, mild, and physiological valve regurgitation (VR) must also be interpreted appropriately. The sophisticated, elegant studies by Williams et al [4][5][6][7][8] from Earl Wood's laboratory at the Mayo Clinic in Roches-ter, Minn, were sensitive for detecting mitral regurgitation (MR) and provided important information. These investigators placed sampling catheters just above and below the mitral valve, and "slight retrograde flow of indicator" was uniformly found in dogs with normal sinus rhythm.…”

Section: See Also Page 1280mentioning

confidence: 99%

Drug-Related Valvular Heart Disease: Here We Go Again: Will We Do Better This Time?

Rahimtoola

2002

Mayo Clinic Proceedings

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Influence of sequence of atrial and ventricular systoles on closure of mitral valve.

Cited by 22 publications

References 0 publications

Pressure-flow studies in man: effect of atrial systole on left ventricular function

Pressure-flow studies in man: effect of atrial systole on left ventricular function

Atriogenic Mitral Valve Reflux: Diastolic Mitral Incompetence Following Isolated Atrial Systoles

Drug-Related Valvular Heart Disease: Here We Go Again: Will We Do Better This Time?

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