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Hemodynamic Effect of Increased Heart Rate in Patients with Prosthetic Mitral Valves.

Onkar S. Narula, M.D.; Joseph W. Linhart, M.D.; Frank J. Hildner, M.D.; S. Serge Barold, M.D.; Roger P. Javier, M.D.; and Philip Samet, M.D., F.A.C.P.
Ann Intern Med. 1969;70(5):1079-1080. doi:10.7326/0003-4819-70-5-1079_3
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Ten patients were studied after mitral valve replacement (six with Beall, two with Starr-Edwards, and two with Kay-Shiley valves). Gradients across the valve were measured by direct left atrial and left ventricular pressures. During atrial pacing in seven patients in normal sinus rhythm (increasing the heart rate from 70 to 134 beats/min), a progressive increase in mitral gradient (7.4 to 11.5 mm Hg, P = 0.001) and left arterial pressure from 10 to 13 mm Hg was noted. Stroke volume and left ventricular end-diastolic pressure decreased from 57 to 36 cc (P = 0.001) and 6.5 to 4.5 mm Hg,


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