{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T21:58:30Z","timestamp":1721858310890},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,2,9]],"date-time":"2015-02-09T00:00:00Z","timestamp":1423440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2015,4,15]]},"abstract":"<jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>A hallmark of mitral stenosis (MS) is the markedly altered left ventricular (LV) loading.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>As most of the methods used to determine LV performance in MS patients are influenced by loading conditions, previous studies have shown conflicting results.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The present study calculated LV elastance, which is a robust method to quantify LV function. We demonstrate that LV loading in MS patients is elevated but normalizes after valve repair and might be a result of reflex pathways.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Additionally, we show that the LV in MS is less compliant than normal due to a combination of right ventricular loading and the valvular disease itself. Immediately after valve dilatation the increase in blood inflow into the LV results in even greater LV stiffness.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Our findings enrich our understanding of heart function in MS patients and provide a simple reproducible way of assessing LV performance in MS.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Left ventricular (LV) function in rheumatic mitral stenosis (MS) remains an issue of controversy, due to load dependency of previously employed assessment methods. We investigated LV performance in MS employing relatively load\u2010independent indices robust to the altered loading state. We studied 106\u00a0subjects (32\u00a0\u00b1\u00a08\u00a0years, 72% female) with severe MS (0.8\u00a0\u00b1\u00a00.2 cm<jats:sup>2<\/jats:sup>) and 40\u00a0age\u2010matched controls. MS subjects underwent simultaneous bi\u2010ventricular catheterization and transthoracic echocardiography (TTE) before and immediately after percutaneous transvenous mitral commisurotomy (PTMC). Sphygmomanometric brachial artery pressures and TTE recordings were simultaneously acquired in controls. Single\u2010beat LV elastance (<jats:italic>E<\/jats:italic><jats:sub>es<\/jats:sub>) was employed for LV contractility measurements. Effective arterial elastance (<jats:italic>E<\/jats:italic><jats:sub>a<\/jats:sub>) and LV diastolic stiffness were measured. MS patients demonstrated significantly elevated afterload (<jats:italic>E<\/jats:italic><jats:sub>a<\/jats:sub>: 3.0\u00a0\u00b1\u00a01.3 <jats:italic>vs<\/jats:italic>. 1.5\u00a0\u00b1\u00a00.3\u00a0mmHg\u00a0ml<jats:sup>\u22121<\/jats:sup>; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and LV contractility (<jats:italic>E<\/jats:italic><jats:sub>es<\/jats:sub>: 4.1\u00a0\u00b1\u00a01.6 <jats:italic>vs<\/jats:italic>. 2.4\u00a0\u00b1\u00a00.5\u00a0mmHg\u00a0ml<jats:sup>\u22121<\/jats:sup>; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) as compared to controls, with higher <jats:italic>E<\/jats:italic><jats:sub>a<\/jats:sub> in subjects with smaller mitral valve area (\u2264 0.8\u00a0cm<jats:sup>2<\/jats:sup>) and pronounced subvalvular fusion. Stroke volume (49\u00a0\u00b1\u00a016 to 57\u00a0\u00b1\u00a017\u00a0ml; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and indexed LV end\u2010diastolic volume (LVEDV<jats:sub>index<\/jats:sub>: 57\u00a0\u00b1\u00a016 to 64\u00a0\u00b1\u00a016\u00a0ml\u00a0m<jats:sup>\u22122<\/jats:sup>; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) increased following PTMC while <jats:italic>E<\/jats:italic><jats:sub>es<\/jats:sub> and <jats:italic>E<\/jats:italic><jats:sub>a<\/jats:sub> returned to more normal levels. Elevated LV stiffness was demonstrated at baseline and increased further following PTMC. Our findings provide evidence of elevated LV contractility, increased arterial load and increased diastolic stiffness in severe MS. Following PTMC, both LV contractility and afterload tend to normalize.<\/jats:p><\/jats:sec>","DOI":"10.1113\/jphysiol.2014.280404","type":"journal-article","created":{"date-parts":[[2015,1,29]],"date-time":"2015-01-29T16:18:20Z","timestamp":1422548300000},"page":"1901-1912","source":"Crossref","is-referenced-by-count":9,"title":["The impact of arterial load on left ventricular performance: an invasive haemodynamic study in severe mitral stenosis"],"prefix":"10.1113","volume":"593","author":[{"given":"Ashwin","family":"Venkateshvaran","sequence":"first","affiliation":[{"name":"School for Technology and Health Royal Institute of Technology  Stockholm Sweden"},{"name":"Sri Sathya Sai Institute of Higher Medical Sciences  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srikanth","family":"Sola","sequence":"additional","affiliation":[{"name":"Sri Sathya Sai Institute of Higher Medical Sciences  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish Chandra","family":"Govind","sequence":"additional","affiliation":[{"name":"School for Technology and Health Royal Institute of Technology  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pravat Kumar","family":"Dash","sequence":"additional","affiliation":[{"name":"Sri Sathya Sai Institute of Higher Medical Sciences  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Banajit","family":"Barooah","sequence":"additional","affiliation":[{"name":"Sri Sathya Sai Institute of Higher Medical Sciences  Bangalore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kambiz","family":"Shahgaldi","sequence":"additional","affiliation":[{"name":"School for Technology and Health Royal Institute of Technology  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Sahl\u00e9n","sequence":"additional","affiliation":[{"name":"School for Technology and Health Royal Institute of Technology  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Lund","sequence":"additional","affiliation":[{"name":"Karolinska Institutet Department of Cardiology Karolinska University Hospital  Stockholm Sweden"},{"name":"Karolinska Institutet Department of Medicine  Solna Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reidar","family":"Winter","sequence":"additional","affiliation":[{"name":"School for Technology and Health Royal Institute of Technology  Stockholm Sweden"},{"name":"Karolinska Institutet Department of Cardiology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anik\u00f3 Ilona","family":"Nagy","sequence":"additional","affiliation":[{"name":"Heart and Vascular Centre Semmelweis University  Budapest Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aristomenis","family":"Manouras","sequence":"additional","affiliation":[{"name":"School for Technology and Health Royal Institute of Technology  Stockholm Sweden"},{"name":"Karolinska Institutet Department of Cardiology Karolinska University Hospital  Stockholm Sweden"},{"name":"Karolinska Institutet Department of Medicine  Solna Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,2,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(77)80340-2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.10.3443"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01651-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.19.2.364"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(72)90162-2"},{"key":"e_1_2_6_7_1","volume-title":"Statistical Methods for Medical and Biological Students","author":"Dahlberg G","year":"1940"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90544-Y"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.80.1.65"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.67.1.148"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.73.6.1310"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.42.6.1099"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(72)90559-0"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.35.5.497"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.64.5.609"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1253\/jcj.52.35"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8651(05)70162-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90366-W"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.2.513"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.41.5.817"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01240.2005"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.74.5.2177"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2004.03625.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.4.1447"},{"key":"e_1_2_6_25_1","first-page":"47","article-title":"Reversal of increased diastolic stiffness in mitral stenosis after successful balloon valvuloplasty","volume":"8","author":"Mayer IV","year":"1999","journal-title":"J Heart Valve Dis"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a014963"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00344-6"},{"key":"e_1_2_6_28_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1152\/ajplegacy.1963.205.2.385","article-title":"Chorda tendinea tension","volume":"205","author":"Salisbury PF","year":"1963","journal-title":"Am J Physiol"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01908165"},{"key":"e_1_2_6_30_1","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1152\/ajplegacy.1975.228.6.1800","article-title":"Papillary muscle dynamics: in situ function and responses of the papillary muscle","volume":"228","author":"Semafuko WE","year":"1975","journal-title":"Am J Physiol"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.35.1.117"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.32.3.314"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.56.4.586"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02584229"},{"key":"e_1_2_6_35_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/S0022-5223(19)37509-9","article-title":"Relationship between left ventricular morphology and postoperative cardiac function following valve replacement for mitral stenosis","volume":"85","author":"Sunamori M","year":"1983","journal-title":"J Thorac Cardiovasc Surg"},{"key":"e_1_2_6_36_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1152\/ajplegacy.1968.214.2.298","article-title":"Effects of decreased aortic compliance on performance of the left ventricle","volume":"214","author":"Urschel CW","year":"1968","journal-title":"Am J Physiol"},{"key":"e_1_2_6_37_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1152\/ajplegacy.1976.231.2.337","article-title":"Left ventricular force\u2013length relations of isovolumic and ejecting contractions","volume":"231","author":"Weber KT","year":"1976","journal-title":"Am J Physiol"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.60.4.299"}],"container-title":["The Journal of Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1113%2Fjphysiol.2014.280404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1113%2Fjphysiol.2014.280404","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/jphysiol.2014.280404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T12:49:37Z","timestamp":1697287777000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/jphysiol.2014.280404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,9]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2015,4,15]]}},"alternative-id":["10.1113\/jphysiol.2014.280404"],"URL":"https:\/\/doi.org\/10.1113\/jphysiol.2014.280404","archive":["Portico"],"relation":{},"ISSN":["0022-3751","1469-7793"],"issn-type":[{"value":"0022-3751","type":"print"},{"value":"1469-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,9]]}}}