Mechanism of mitral leaflet excursion

J. M. Dent, W. D. Spotnitz, S. P. Nolan, A. R. Jayaweera, W. P. Glasheen, S. Kaul

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


The factors that influence the extent of mitral leaflet opening (MLO) and closure (MLC) have not been defined. We hypothesized that left ventricular (LV) systolic function determines the rate of increase of the early diastolic left atrial (LA)-LV pressure gradient, which is responsible for the extent of MLO, and also the rate of change of the early systolic LV-LA pressure gradient, which determines the degree of MLC. Accordingly, global LV function was changed by altering left main coronary artery flow with LA pressure held relatively constant. LV end-systolic dimension and peak positive LV rate of pressure development (dP/dt) correlated best with the degrees of MLO and MLC, with average correlation coefficients of 0.88 and 0.68, and 0.86 and 0.72, respectively. Although transsecting the submitral apparatus resulted in flailing of the mitral leaflets during normal LV systolic function, the extents of MLO and MLC during LV systolic dysfunction were still influenced by LV systolic function. It is concluded that LV systolic function determines the extent (both opening and closure) of mitral leaflet excursion.

Original languageEnglish (US)
Pages (from-to)H2100-H2108
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Issue number6 38-6
StatePublished - 1995
Externally publishedYes


  • left ventricular systolic function
  • mitral leaflet closure
  • mitral leaflet opening

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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