In patients with primary mitral regurgitation, resting regurgitant volume correlated positively with resting pulmonary capillary wedge pressure (r=0.42, p=0.002), but this association disappeared during exercise.
Observational
How do cardiac morphology and function correlate with resting and exercise haemodynamics in patients with primary mitral regurgitation?
In primary mitral regurgitation, regurgitant volume and left atrial dilatation correlate with resting but not exercise pulmonary capillary wedge pressure, with exercise-induced PCWP elevation suggesting lower LV compliance.
Effect estimate: r = 0.42
p-value: p=0.002
Objective: To assess the association between cardiac morphology and function assessed with cardiac MRI (CMRI) and haemodynamics at rest and during exercise in patients with primary mitral regurgitation (MR). Methods: and left ventricular (LV) ejection fraction > 60% were examined with right heart catheterisation during rest and exercise and CMRI at rest. End-diastolic pressure volume relationship (EDPVR) was assessed using a single beat method using pulmonary capillary wedge pressure (PCWP) and end-diastolic volume. Patients were divided according to normal PCWP at rest (> 12 mm Hg) and with exercise (> 28 mm Hg). Results: Resting regurgitant volume correlated positively with resting PCWP, (r = 0.42, p = 0.002). However, with exercise no association between PCWP and regurgitant volume was seen (r = 0.09, p = 0.55). At rest left atrial (LA) maximal, minimal and volume index at atrial contraction correlated positively with PCWP (r = 0.60; r = 0.55; r = 0.58, all p 0.2). EDPVR in patients with high PCWP at rest was shifted towards higher volumes for the same pressures. The opposite was seen for patients with high PCWP during exercise where estimated volumes were smaller for the same pressure than patients with normal exercise PCWP. Conclusion: In patients with significant MR the degree of regurgitation and LA dilatation is associated with resting PCWP. However, with exercise this association disappears. Estimation of EDPVR suggests lower LV compliance in patients where PCWP is increased with exercise. Clinical trial registration: URL: https://clinicaltrials.gov/ct2/show/NCT02961647?term=HEMI&rank=1. ID: NCT02961647.
Bakkestrøm et al. (Sat,) conducted a observational in Primary mitral valve regurgitation. Resting regurgitant volume and left atrial volume was evaluated on Association between cardiac morphology/function and haemodynamics (PCWP) at rest and during exercise (r = 0.42, p=0.002). In patients with primary mitral regurgitation, resting regurgitant volume correlated positively with resting pulmonary capillary wedge pressure (r=0.42, p=0.002), but this association disappeared during exercise.