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 ventricular volume and left ventricular mass (LVM) in 100 patients with isolated mitral valve disease. Thirty-six patients had mitral stenosis (MS), 29 had mitral regurgitation (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 regurgitation, 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.