Detection and Assessment of Mitral Regurgitation by Left Atrial Indicator-Dilution Curves

Abstract

Indicator-dilution curves were recorded simultaneously from the left atrium and the femoral artery during injections of indocyanine green into the left ventricle in normal dogs and in dogs with chronic mitral regurgitation. A study was made-without the use of thoracotomy-of the effect of the following factors on the amount of early appearing indicator detected in the left atrium: (a) the timing of the injection of indicator in relation to the cardiac cycle, (b) the position of the injecting catheter in the left ventricle, and (c) the position of the sampling catheter in the left atrium. It was found that the time and site of the injection into the left ventricle had little effect on the amount of early appearing dye detected in the left atrium and that, although the position of the sampling catheter in the left atrium was important, reproducible results were attained when the sampling site was restricted to a region in close proximity to the mitral valve. A close correlation was demonstrated between the volume of regurgitation determined independently on a hydraulic basis and the volume estimated from the fraction of early appearing indicator detected in the left atrium. It is concluded that further work with this upstream-sampling technique is justified in order to study its possibilities as a practical method for detecting and quantitating mitral regurgitation in human beings.