Rapid Left Ventricular Filling and Stasis in Mitral Regurgitation

In 1902 Mackenzie described the jugular pulse tracing from a patient with atrial fibrillation (Fig. 1). Pressure declined as the ventricle filled, and rose again before the ventricle contracted. He took this to be a sign that the ventricle filled some time before it contracted, and attributed the rise in venous pressure to stasis. In 1906 Yandell Henderson described the volume changes of the beating mammalian heart and showed that ventricular filling is accomplished rapidly during a phase that begins with the opening of the atrio-ventricular valve and ends with the muscle ceasing to relax. Blood flow into the ventricle is negligible during the remainder of diastole. He gave the name diastasis to the latter period of "rest " or stasis to distinguish it from the former phase of "ventricular relaxation and refilling". Furthermore he confirmed Mackenzie's observation that FIG. 1.-Simultaneous tracings of the jugular and radial pulses, showing period of stasis from y to v. alterations in heart rate are effected almost entirely by the lengthening or shortening of the period of stasis. Gibson (1907) and Hirschfelder (1907) described jugular venous stasis waves and third heart sounds in healthy young persons, and the latter referred to the waves as "h " waves. Wiggers (1921) observed that left atrial pressure in the dog declines during the phase of rapid ventricular filling and may rise again before the next atrial contraction if the heart rate is slow