Determinants of exercise-induced changes in mitral regurgitation in patients with coronary artery disease and left ventricular dysfunction
Patrizio Lancellotti, MD*,
Frédéric Lebrun, MD* and
Luc A. Piérard, MD, FESC*,*
* Department of Cardiology, University Hospital of Liège, Liège, Belgium
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Figure 1 (Left) Parasternal long-axis view of aorta (Ao), left ventricle (LV), and left atrium (LA) showing tenting area (TA). (Right) Apical long-axis view demonstrating measurement of the distance between the posterior papillary muscle and the intervalvular fibrosa (arrowheads).
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Figure 2 Apical four-chamber view showing color-flow Doppler and proximal flow-convergence region at rest and during exercise in a patient with a large exercise-induced increase in mitral regurgitation. r = proximal isovelocity surface area (PISA) radius.
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Figure 3 Correlation between changes in effective regurgitant orifice (ERO) during exercise and the degree of mitral regurgitation at rest.
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Figure 4 Correlation between changes in effective regurgitant orifice (ERO) and changes in tenting area during exercise.
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Figure 5 End-systolic stop frame images and proximal flow-convergence region at rest and during exercise in a patient with chronic inferior myocardial infarction and mitral regurgitation. Contractile reserve of the basal inferior wall is recruited during exercise and is associated with a reduction of the proximal isovelocity surface area radius and a decrease in effective regurgitant orifice.
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