[The possibility of determining the functional status of the hypertrophied myocardium in multiple valvular defects of the heart].

A comprehensive angiocardiographic study with computer-aided data processing were performed in 46 patients (mean age 34.2 years) with multivalvular diseases. Thirty two patients were diagnosed as having mitral and aortic defect, 14 had mitral, aortic and tricuspid defect. Three-valve disease, unlike two-valve disease, showed a "paradoxical" improvement in some parameters, such as end-diastolic volume, end-systolic volume, myocardial mass, ventricular performance rates. An analysis of circular intramyocardial tension, coronary sinus blood oxygen extraction and saturation indicated that myocardial function was less intensive in three-valve disease, suggesting the compensatory pattern of tricuspid valve involvement. However, this "compensation" results in a further decrease in cardiac output and cannot be regarded as a genuine compensation. In multivalvular disease, the integral intramyocardial tension and its ratio to coronary sinus blood oxygen saturation may serve as the only diagnostic criterion for myocardial dysfunction and a predictor in determining the outcome of surgical intervention.