TY - JOUR
T1 - Factors influencing pulmonary venous flow velocity patterns in mitral regurgitation
T2 - An in vitro study
AU - Passafini, Arnaldo
AU - Shiota, Takahiro
AU - Depp, Marianne
AU - Paik, Juliana
AU - Ge, Shuping
AU - Shandas, Robin
AU - Sahn, David J.
N1 - Funding Information:
From the Clinical Care Center lor Congenital tfcart Disease, Oregon Health Sciences University, Portland. Oregon. This study was supported by Grant HL43287 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
PY - 1995/11/1
Y1 - 1995/11/1
N2 - Objectives.: The aim of this study was to investigate factors affecting pulmonary venous flow patterns in mitral regurgitation. Background.: Although pulmonary venous flow velocity patterns have been reported to be helpful in assessing the severity of mitral regurgitation, the influence of regurgitant jet direction, pulmonary venous location and left atrial pressures on pulmonary venous flow patterns has yet to be clarified. Methods.: The mitral regurgitant jet was produced by a pulsatile piston pump at 10, 30 and 40 ml/beat through a circular orifice, whereas the pulmonary venous flow was driven by gravity. Four different patterns of pulmonary venous flow and mitral regurgitation were examined. The V wave pressure was set at 10, 30 and 50 mm Hg and pulmonary venous flow velocity at 30 cm/s. Color and pulsed Doppler recordings were obtained with a VingMed 800 scanner interfaced with a computer facilitating digital analysis. Results.: The decrease in the velocity time integral of pulmonary venous flow was more prominent for any given volume of mitral regurgitation at higher left atrial pressure. When the mitral regurgitant jet was directed toward the pulmonary vein, a more prominent decrease in the velocity time integral was seen, especially for severe mitral regurgitation (40 ml) with high left atrial pressure (95% vs. 55%, p < 0.001); and the time to peak deceleration of forward flow was significantly shorter (485 vs. 523 ms, respectively, p < 0.01). Also, two different types (laminar and turbulent) of reversed pulmonary venous flow were observed. Conclusions.: Multiple factors, including jet direction, mitral regurgitant volume and left atrial pressure, determine the effect of mitral regurgitation on pulmonary venous flow velocity patterns.
AB - Objectives.: The aim of this study was to investigate factors affecting pulmonary venous flow patterns in mitral regurgitation. Background.: Although pulmonary venous flow velocity patterns have been reported to be helpful in assessing the severity of mitral regurgitation, the influence of regurgitant jet direction, pulmonary venous location and left atrial pressures on pulmonary venous flow patterns has yet to be clarified. Methods.: The mitral regurgitant jet was produced by a pulsatile piston pump at 10, 30 and 40 ml/beat through a circular orifice, whereas the pulmonary venous flow was driven by gravity. Four different patterns of pulmonary venous flow and mitral regurgitation were examined. The V wave pressure was set at 10, 30 and 50 mm Hg and pulmonary venous flow velocity at 30 cm/s. Color and pulsed Doppler recordings were obtained with a VingMed 800 scanner interfaced with a computer facilitating digital analysis. Results.: The decrease in the velocity time integral of pulmonary venous flow was more prominent for any given volume of mitral regurgitation at higher left atrial pressure. When the mitral regurgitant jet was directed toward the pulmonary vein, a more prominent decrease in the velocity time integral was seen, especially for severe mitral regurgitation (40 ml) with high left atrial pressure (95% vs. 55%, p < 0.001); and the time to peak deceleration of forward flow was significantly shorter (485 vs. 523 ms, respectively, p < 0.01). Also, two different types (laminar and turbulent) of reversed pulmonary venous flow were observed. Conclusions.: Multiple factors, including jet direction, mitral regurgitant volume and left atrial pressure, determine the effect of mitral regurgitation on pulmonary venous flow velocity patterns.
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U2 - 10.1016/0735-1097(95)00322-3
DO - 10.1016/0735-1097(95)00322-3
M3 - Article
C2 - 7594051
AN - SCOPUS:0028840594
SN - 0735-1097
VL - 26
SP - 1333
EP - 1339
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 5
ER -