Negative intraventricular diastolic pressure in patients with mitral stenosis: evidence of left ventricular diastolic suction.

Left ventricular diastolic pressure was evaluated in 15 patients with mitral stenosis and 16 patients with no significant heart disease to determine if a stenotic mitral valve can cause the left ventricle to produce a negative diastolic pressure, indicative of ventricular diastolic suction. The minimal level of diastolic pressure in patients with mitral stenosis ranged between 6 and -7 mm Hg; in normal subjects it did not fall below 0. The average value of minimal diastolic pressure in patients with mitral stenosis (-2 +/- 1 mm Hg [mean +/- standard error of the mean]) was significantly lower than in patients without significant heart disease (5 +/- 1 mm Hg) (p less than 0.001). These observations indicate that the human left ventricle, in the presence of mitral stenosis, can generate a negative diastolic pressure. The presence of a negative diastolic pressure in patients with mitral stenosis suggests that the dynamics of the ventricle during diastole may contribute to the filling process.