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Patients with signs and symptoms of MR with severely depressed systolic function (ie, EF <30%) can present a difficult diagnostic and management dilemma. It can be difficult to establish whether the primary problem is that of MR causing LV dilatation and dysfunction or a cardiomyopathic process leading to secondary (ie, “functional”) MR.
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Mean pulmonary artery pressure (PA) and PC were used to calculate pulmonary arteriolar resistance (PA — PC/cardiac output) in arbitrary units. Left ventricular diastolic pressures were measured immediately prior to atrial systole (LV pre “a” .Fractional Shortening = (LVEDD – LVESD) / LVEDD x 100. Where: LVEDD = left ventricular end-diastolic diameter. LVESD = left ventricular end-systolic diameter. Fractional shortening is a measure of how well the left ventricle is contracting itself and therefore reduces the size during systole: Normal FS, M-mode: >25%.
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