Why the study?
Does acutely increased systemic resistance via norepinephrine infusion help detect mitral insufficiency by elevating left atrial v point pressure?
Does acutely increased systemic resistance via norepinephrine infusion help detect mitral insufficiency by elevating left atrial v point pressure?
Acutely increasing systemic resistance with norepinephrine during left heart catheterization significantly elevates the left atrial v point pressure in patients with mitral insufficiency, providing a hemodynamic method for its clinical detection.
Left atrial v-wave ratios may aid mitral insufficiency detection during catheterization; leaves open validation against modern imaging.
In 1921, Wiggers and Feil in a study of experi-mental mitral insufficiency observed an elevation of left atrial pressure when the aorta was con-stricted (1). This finding has subsequently been confirmed both in experimental animals (2, 3) and in a circulatory model (4). In recent experi-ments "mitral " regurgitant flow was produced and measured by permitting blood to pass from the left ventricle through a flow meter into the left atrium (5). It was observed that with any given mitral regurgitant orifice the regurgitant flow could be substantially increased by elevating the resistance to left ventricular ejection with graded aortic constriction. The experimental observations listed above sug-
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Braunwald et al. (1958) studied this question.
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