title: Diastolic mitral regurgitation: a borderline case in cardiovascular physiology.
abstract: BACKGROUND
  Mitral regurgitation during diastole in 5 subjects, of whom 4 affected by cardiovascular disease and 1 healthy competitive athlete, was the aim of this work. The 4 patients are respectively affected by: 1st case: arterial hypertension, dyslipidemia and III degree AV block in NYHA class II heart failure (HF); 2nd case: NYHA III HF, prosthetic biologic aortic valve dysfunction; 3th case: NYHA III HF, ischemic dilated cardiomyopathy; 4th case: ischemic dilated cardiomyopathy waiting for heart transplantation.
  
  
  RESULTS
  The above 4 patients showed, on transthoracic echocardiogram, mitral diastolic regurgitation. The authors deem as caused, in agreement with the literature, both by an atrio-ventricular pressure gradient inversion during long-lasting diastoles (III degree atrioventricular block, blocked atrial systole, aortic valve regurgitation), and by an inadequate ventricular remodelling/distensibility. The 5th case deals with a healthy highly trained competitive athlete who, at the fitness checkup, showed mitral diastolic regurgitation. The study was also extended to two healthy groups of subjects, in order to rule out mitral regurgitation during the diastolic interval of the cardiac cycle.
  
  
  CONCLUSIONS
  Such finding, after an accurate and critical analysis, led the authors to assume it may deal with a borderline physiological condition.
authors.affiliation: Dipartimento Scienze Cardiovascolari e Respiratorie, University of Rome "La Sapienza", Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Alessandri
authors.forename: S
authors.initials: S
authors.lastname: Mariani
authors.forename: F R
authors.initials: FR
authors.lastname: Messina
authors.forename: G
authors.initials: G
authors.lastname: Rondoni
authors.forename: E
authors.initials: E
authors.lastname: Gerbasi
authors.forename: L
authors.initials: L
authors.lastname: Battista
authors.forename: C
authors.initials: C
authors.lastname: Gaudio
mesh_terms: D000328:Adult; D000368:Aged; D002320:Cardiovascular Physiological Phenomena; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010807:Physical Endurance; D013177:Sports / Q000502:physiology