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The mechanism of decrease in dynamic mitral regurgitation during heart failure treatment: importance of reduction in the regurgitant orifice size

^a Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

View larger version (22K): [in a new window]   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.

View larger version (21K): [in a new window]   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.

View larger version (17K): [in a new window]   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.