The mechanism of decrease in dynamic mitral regurgitation during heart failure treatment: importance of reduction in the regurgitant orifice size
Luis B. Rosario, MDa,
Lynne W. Stevenson, MD, FACCa,
Scott D. Solomon, MD, FACCa,
Richard T. Lee, MD, FACCa and
Sharon C. Reimold, MD, FACCa
a Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
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Figure 1 The regurgitant volume calculated using proximal isovelocity surface area methods is shown before and after therapy. The mitral regurgitant volume decreased from 47 ± 27 ml prior to therapy to 14 ± 14 ml after therapy, p < 0.001. The fall in regurgitant volume was noted for all patients enrolled in the study.
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Figure 2 The regurgitant orifice area is shown before and after therapy. The regurgitant orifice area decreased significantly from 0.55 ± 0.38 cm2 to 0.21 ± 0.20 cm2 (p < 0.001, Fig. 2). There was a decrease in the regurgitant orifice area in all patients.
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Figure 3 Changes in the regurgitant orifice area over time are shown for one patient prior to therapy (solid line) and after therapy (dotted line). While there is a decrease in regurgitant orifice area throughout systole, the orifice remains the largest early in systole.
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