Effects of physiologic maneuvers on cardiac performance and mitral regurgitation in patients with dilated cardiomyopathy

Objective We observed systolic function by using Doppler echocardiography during valsalva (VM), handgrip, standing and leg elevation maneuvers in patients with mitral regurgitation (MR). Methods Patient population consisted with 32 patients with dilated cardiomyopathy. Patient population was consisted of only men and average age are 60 years. They were in functional class ll to lll according to the New York Heart Association classification. None of the patients had primary mitral valve disease, flail mitral leaflet or aortic regurgitation. Left ventricular ejection fraction averaged 38±12 %. Subjects with technically unsatisfactory echocardiograms were excluded from the study. Left ventricular end diastolic volume was substantially over in all patients. Results HG was increased severity of MR (+23, p<0.05), area of MR (MRA) (+28, p<0.05) and regurgitation fraction (RF) (+17, p<0.05) with increasing afterload. VM and standing were decreased mitral regurgitation volume (-15, p<0.05), MRA (-21, -20, p<0.05). Leg claration was ineffective for changing severity of MR and systolic function (p>0.05). Conclusion Our findings demonstrate that bedside maneuvers affected the systolic function and severity of MR due to loading conditios.