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Left ventricular endocardial longitudinal and transverse changes during isovolumic contraction and relaxation: a challenge

The International Heart Institute of Montana Foundation, St. Patrick Hospital and Health Sciences Center and The University of Montana, Missoula, Montana

Submitted 24 August 2004 ; accepted in final form 17 January 2005

Left ventricular (LV) longitudinal and transverse geometric changes during isovolumic contraction and relaxation are still controversial. This confusion is compounded by traditional definitions of these phases of the cardiac cycle. High-resolution sonomicrometry studies might clarify these issues. Crystals were implanted in six sheep at the LV apex, fibrous trigones, lateral and posterior mitral annulus, base of the aortic right coronary sinus, anterior and septal endocardial wall, papillary muscle tips, and edge of the anterior and posterior mitral leaflets. Changes in distances were time related to LV and aortic pressures and to mitral valve opening. At the beginning of isovolumic contraction, while the mitral valve was still open, the LV endocardial transverse diameter started to shorten while the endocardial longitudinal diameter increased. During isovolumic relaxation, while the mitral valve was closed, LV transverse diameter started to increase while the longitudinal diameter continued to decrease. These findings are inconsistent with the classic definitions of the phases of the cardiac cycle.

mitral valve; ventricles; hemodynamics; isovolumic contraction; isovolumic relaxation; mitral valve closure; cardiac cycle phases; left ventricle diameters

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