Quantitative Angiocardiography IV. Relationships of Left Atrial and Ventricular Pressure and Volume in Mitral Valve Disease

Quantitative angiocardiographic methods have been used to determine left ventricu-lar volume and left ventricular mass (LVM) in 100 patients with isolated mitral valve disease. Thirty-six patients had mitral stenosis (MS), 29 had mitral regurgi-tation (MR), and 35 had combined stenosis and regurgitation (MS + MR). Data on volume and LVM from these patients are presented and are related to standard flow and intracardiac pressure determinations and compared with normal values. In patients with MS, the mean end-diastolic volume per square meter of body surface area (EDV/m2) was 72 ml/m2 and was increased to 148 ml/m2 in those with MR. EDV/m2 correlated closely with the severity of regurgitation and less well with LV end-diastolic pressure. The mean LV stroke volume was slightly smaller than normal in patients with MS (38 ml/m2) and was greatly increased in those with MR (88 ml/M2). The LV stroke volume correlated closely with the severity of regurgitation, r = 0.928. The ejection fraction (EF) was low in 37 % of patients with MS and in 22 % of those with MS + MR and MR alone. Left atrial volume was larger than normal in all patients and, although generally larger in those with re-gurgitation, did not correlate with its severity. In contrast, cyclic left atrial volume change was correlated with the severity of mitral regurgitation, r = 0.785. The data are presented with cumulative distribution curves suitable for reference standards. Additional Indexing Words: Ejection fraction Left ventricular volume and mass T HE hemodynamic evaluation of patients with mitral valve disease generally has-been limited to measurement of atrial and ventricular pressure, calculation of the mitral valve area, and gross estimation of the severity of mitral regurgitation from angiocardio-grams. Although these methods give usefu