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Am J Physiol Heart Circ Physiol 283: H1929-H1935, 2002. First published June 20, 2002; doi:10.1152/ajpheart.00149.2002
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Vol. 283, Issue 5, H1929-H1935, November 2002

Atrial contraction and mitral annular dynamics during acute left atrial and ventricular ischemia in sheep

Tomasz A. Timek1, David T. Lai1, Frederick Tibayan1, George T. Daughters1,2, David Liang3, Paul Dagum1, Sidney Lo3, D. Craig Miller1, and Neil B. Ingels Jr.1,2

1 Department of Cardiothoracic Surgery and 3 Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford 94305; and 2 Laboratory of Cardiovascular Physiology and Biophysics, Research Institute, Palo Alto Medical Foundation, Palo Alto, California 94301

In six sheep, radiopaque markers were placed on the left ventricle (LV), the mitral annulus, the left atrium (LA), and the central edge of both mitral leaflets to investigate the effects of acute LV ischemia on atrial contraction, mitral annular area (MAA), and mitral regurgitation (MR). Animals were studied with biplane videofluoroscopy and transesophageal echocardiography before and during balloon occlusion of the left anterior descending (LAD), distal circumflex (dLCX), and proximal circumflex (pLCX) coronary arteries. MAA and LA area were calculated from the corresponding markers. LAD occlusion did not alter LA area reduction or presystolic MAA reduction, whereas dLCX occlusion resulted in a mild decrease in the former with no change in the latter. Neither occlusion resulted in MR. pLCX occlusion, however, significantly decreased LA area and presystolic MAA reduction and resulted in increased end-diastolic MAA, delayed valve closure from end diastole, and MR. Decreased atrial contractile function, as observed during acute posterolateral ischemia, is linked to diminished presystolic mitral annular reduction, a larger mitral annular size at end diastole, and MR.

mitral annulus; left ventricular ischemia; mitral regurgitation


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