Does left atrial contraction contribute differently to left ventricular filling in patients with aortic stenosis compared to mitral stenosis or controls?
Left atrial contraction plays a significantly more important role in left ventricular filling and performance in patients with aortic stenosis compared to those with mitral stenosis or normal controls.
The relationship of left atrial contraction to ventricular filling was studied in 24 patients. Eight patients had aortic stenosis, eight had mitral stenosis, and eight others served as a control group. All had normal sinus rhythm. Cineangiocardiographic volumetric determinations of the left ventricle were done throughout the cardiac cycle, and the rate of left ventricular filling before and during left atrial contraction was calculated. In the group with aortic stenosis 39% of the left ventricular stroke volume entered the ventricle during left atrial contraction; in the group with mitral stenosis 24% was contributed during left atrial contraction, and in the control patients, 26%. The rate of left ventricular filling more than doubled during left atrial contraction in aortic stenosis, while no consistent change in the rate of filling occurred during left atrial contraction in mitral stenosis and in the control group. The character of the resistance to left ventricular filling in aortic stenosis and mitral stenosis is discussed. An important contribution by left atrial contraction to left ventricular performance in aortic stenosis is suggested.
STOTT et al. (Mon,) studied this question.