Echocardiographic Evaluation of Left Ventricular Filling in Mitral Stenosis Role of Atrial Contraction

Abstract

The significant reduction of rapid filling volume was observed and the rate of rapid filling was approximately half of normal in mitral stenosis. The rapid filling period showed a good correlation to the mitral valve area measured at operation. After surgical treatment, the rate of rapid filling was significantly increased but was still significantly smaller than normal. The remained structural abnormality of mitral apparatus apparently depressed the inflow through the mitral valve in early diastole despite successful mitral valvotomy. Left ventricular filling during atrial contraction (atrial filling) was augmented twice as much as normal in patients with milder mitral stenosis, compensating the decreased early diastolic filling. The atrial filling did not increase in severe mitral stenosis, resulting in the decreased cardiac output. Following mitral commissurotomy, the atrial filling in milder mitral stenosis was reduced but remained significantly larger than normal. There was no change of atrial filling in severe mitral stenosis postoperatively. Impaired contraction of left atrium in cases with severe mitral stenosis possibly exists. The altered left atrial transport function plays an important role in the left ventricular filling in mitral stenosis.