Letter by Sengupta et al Regarding Article, “Mechanisms of Preejection and Postejection Velocity Spikes in Left Ventricular Myocardium: Interaction Between Wall Deformation and Valve Events”

Abstract

To the Editor: We read with great interest the article by Remme et al.1 Although the study implies a strong association between the preejection and postejection phases and velocity spikes, we believe there are several aspects of heterogeneity in myocardial mechanics that merit further discussion. In the experiments, the creation of acute mitral regurgitation reduced the preejection spike. However, left ventricular (LV) pressure was also reduced (eg, from >80 mm Hg to about <40 mm Hg, as shown in Figure 1 of the article by Remme et al). Therefore, the marked reduction in the preejection velocity spike may reflect reduction in preejection pressure …