Correlation of degree of left ventricular volume overload with clinical course in aortic and mitral regurgitation

The results of left ventricular volume studies using biplane angiocardiography are described in 20 patients with mitral regurgitation and in 27 patients with aortic regurgitation. In both lesions, a regurgitant fraction of over 60 per cent was likely to be associated with severe symptoms and most patients in this group required operation. End-diastolic volumes were higher in patients with aortic regurgitation and were tolerated with fewer symptoms than in the group with mitral regurgitation. Most (19/21) of the patients with low ejection fractions (<0.60) had either rheumatic valvular lesions or had had potassium citrate as a cardioplegic drug at previous heart operations. The possible myocardial effects of these factors are discussed. Left ventricular volume studies have proved useful in the assessment of valvular regurgitation by quantitating regurgitant flow and giving a measure of the relative importance of valvular and myocardial disease.