Mitral valve coaptation and its relationship to late diastolic flow: A color Doppler and vector flow map echocardiographic study in normal subjects.
Background Three competing theories about the mechanism of mitral coaptation in normal subjects were evaluated by color Doppler and vector flow mapping ( VFM): (1) beginning of ventricular ( LV) ejection, (2) 'breaking of the jet' of diastolic LV inflow, and (3) returning diastolic vortices impactin...
| Publicado en: | Echocardiography Vol. 34; no. 4; pp. 537 - 549 |
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| Autores principales: | , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122314339&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122314339 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Apr2017 vid: 34 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 122314339 122314339 122314339 10.1111/echo.13480 122314339 ppf: 537 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Mitral valve coaptation and its relationship to late diastolic flow: A color Doppler and vector flow map echocardiographic study in normal subjects. aug: au: Sherrid, Mark V. Kushner, Josef Yang, Georgiana Ro, Richard affil: Division of Cardiology, New York University Langone Medical Center, New York City NY, USA sug: subj: Mitral Valve Physiology Echocardiography, Doppler, Color Methods Human Mitral Valve Insufficiency One-Way Analysis of Variance Post Hoc Analysis Paired T-Tests Male Female Adult Middle Age Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background Three competing theories about the mechanism of mitral coaptation in normal subjects were evaluated by color Doppler and vector flow mapping ( VFM): (1) beginning of ventricular ( LV) ejection, (2) 'breaking of the jet' of diastolic LV inflow, and (3) returning diastolic vortices impacting the leaflets on their LV surfaces. Methods and Results We analyzed 80 color Doppler frames and 320 VFM measurements. In all 20 normal subjects, coaptation occurred before LV ejection, 78±16 ms before onset. On color Doppler frames the larger anterior, and smaller posterior vortices circle back and, in all cases, strike the ventricular surfaces of the leaflets. On the first closing-begins frame, for the first time, vortex velocity normal to the ventricular surface of the anterior leaflet ( AML) is greater than that in the mitral orifice, and the angle of attack of LV vortical flow onto the AML is twice as high as the angle of flow onto the valve in orifice. Thus, at the moment coaptation begins, vortical flow strikes the mitral leaflet with higher velocity, and higher angle of attack than orifice flow, and thus with greater force. According to the 'breaking of the jet' theory, one would expect to see de novo LV flow perpendicular to the leaflets beginning after transmitral flow terminates. Instead, the returning continuous LV vortical flow that impacts the valve builds continuously after the P-wave. Conclusions Late diastolic vortices strike the ventricular surfaces of the mitral leaflets and contribute to valve coaptation, permitted by concomitant decline in transmitral flow. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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