[20-year prognosis of closed mitral commissurotomy. II. Length of survival and postoperative embolism].
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Biomedical subjects
Publications and source records attributed to V Jezek.
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The authors investigated the left ventricular systolic function and diastolic characteristic in 25 patients with mitral stenosis and compared the results with findings in 25 healthy subjects. The patients with mitral stenosis differed from the control group by elevated left ventricular filling pressure, greater left ventricular end-diastolic volume, reduced ejection fraction, and decreased calculated left ventricular compliance. Pathological values of these indicators, however, were infrequent and as a rule only slightly exceeded the normal limits. The decrease in left ventricular compliance had significant correlations with the degree of pulmonary arterial hypertension, elevation of right ventricular filling pressure, the ratio of filling pressures of both ventricles, and left ventricular end-systolic eccentricity. Consequently, the authors infer that the main factor decreasing the left ventricular compliance in mitral stenosis is the aberrant geometry of the ventricle. The authors also point out the correlations between the left ventricular systolic function and diastolic characteristics in mitral stenosis, and assume that this affection represents a complex, although not too advanced, disturbance of left ventricular function.
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Nineteen patients with chronic cor pulmonale, in which the coincidence with other cardiovascular disease was excluded by cardiac catheterization and coronary arteriography, were examined. Left ventricular hypertrophy, elevated filling pressure and reduced compliance were found in a part of the patients. The left ventricular ejection fraction was normal and had no correlation with the elevated filling pressures. These abnormalities were related to the degree of pulmonary hypertension; furthermore, the correlation between the left ventricular hypertrophy and reduced compliance has been found. The author concludes that chronic obstructive bronchopulmonary disease is not accompanied by left ventricular contractile insufficiency; the left ventricle is able to develop a normal systolic performance at rest. In a part of patients, however, this systolic performance is developed at certain abnormal haemodynamic conditions, particularly at elevated left ventricular filling pressure. Possible mechanisms responsible for these alterations are discussed.
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