[Relationship between volume reduction of the left ventricle and the increase of mitral valve prolapse. An experimental study in dogs]. / Relação entre redução volumétrica do ventrículo esquerdo e incremento do prolapso da valva mitral. Um estudo experimental em cães.

ABSTRACT

PURPOSE: To verify whether accentuated reductions of left ventricular volume lead to mitral valve prolapse. METHODS: Seven mongrel dogs were bled through the internal jugular vein, the systolic systemic pressure being kept between 100 and 140 mmHg by means of continuous infusion of dopamine; the inferior vena cava vein, in tree other dogs, was partially obstructed for 4 to 6 seconds; epicardial echocardiography was carried out in all cases. RESULTS: Reductions of volemia were about 50% of the estimated total blood volume. Systolic internal diameter of left ventricle decreased about 25% and systolic ostial diameter, about 12.5%. Three out of seven died suddenly from arrhythmia before one has reached a significant decrease in total blood volume; one showed momentary mitral valve prolapse, during a period of hypotension; however, this prolapse disappeared completely when systemic blood pressure was restored by increasing the dopamine dosage; one dog had slight systolic displacement of the anterior cusp toward left atrium (0.5mm) and the last two showed no change; one out of 3 dogs submitted to partial constriction of inferior vena cava had systolic displacement of anterior cusp of 1mm; in one case there was an equivalent degree of displacement of the anterior cusp toward the left ventricle and in the last one no change was detected. In all dogs there was a change in the dynamics of mitral valve closure with accentuated reduction of left ventricular volume the posterior cusp became less mobile, the anterior cusp being the principal responsible for the systolic ostial occlusion. CONCLUSION: Accentuated reduction of dog's left ventricular volume does not, necessarily, cause mitral valve prolapse but only slight displacement of the anterior cusp toward the left atrium in some animals or no displacement at all.