Echocardiographic left ventricular function in aortic and mitral incompetence and the effect of valve replacement.

Left ventricular (LV) function was studied by echocardiography in 28 patients with volume overload of the LV before and after valve replacement. Of the 28 subjects, 19 had mitral valve disease (eight with mitral incompetence and 11 with mitral incompetence and stenosis) and nine patients had aortic incompetence. Patients with chronic mitral and aortic incompetence had marked LV enlargement with normal or slightly depressed systolic function; in those with acute mitral incompetence the degree of cardiomegaly was less and the state of LV function depended on the underlying cause of valvular incompetence. Valve replacement was followed by a decrease in LV end-diastolic volume and this occurred in the first week after operation. There was a gradual improvement in LV function in some patients, as measured by normalized mean velocity of posterior LV wall motion. Paradoxical septal motion occurred in many patients after operation but improved in the late postoperative period.