894 Valve resistance variation with exercise in patients with aortic stenosis. New methodology

Cotrim, Carlos; Vinhas, Hugo; Simões, Otília; Loureiro, Marília; Mendes, N.; Cordeiro, Pedro; João, I.; Oliveira, M.; Carrageta, Manuel

doi:10.1016/s1525-2167(03)91015-8

Cited by 1 publication

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“…exercise, Valsalva manoeuvre, eating a large meal and dehydration) may unmask or worsen LVOTO. Conversely, LVOTO may be less evident in other circumstances (including systemic hypertension) [9].…”

Section: Mitral Valve Abnormalities In Hypertrophic Cardiomyopathymentioning

confidence: 99%

The mitral valve in hypertrophic cardiomyopathy

Malcolmson

Shipolini

Mohiddin

et al. 2023

Current Opinion in Cardiology

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Purpose of review Whilst abnormally increased left ventricular wall thickness is the hallmark feature of hypertrophic cardiomyopathy (HCM), anomalies of the mitral valve and supporting apparatus are well documented. This review addresses the clinical importance of mitral valve abnormalities in HCM, their mechanistic associations with symptoms, and therapeutic strategies targeting mitral valve and apparatus abnormalities. Recent findings The normal mitral valve possesses anatomical features facilitating unrestricted blood flow during LV filling, preventing regurgitation during LV systole, and avoiding obstruction of LV ejection. In HCM, a variety of structural and functional abnormalities can conspire to cause deranged mitral valve function, with implications for management strategy. Identification and characterization of these abnormalities is facilitated by multimodality imaging. Alcohol septal ablation (ASA) cannot address primary mitral valve abnormalities, and so is not preferred to surgical intervention if mitral valve abnormalities are present and are judged to make dominant contributions to LV outflow tract obstruction (LVOTO). Two broadly opposing surgical intervention strategies exist, one advocating isolated septal myectomy and the other including adjuvant mitral apparatus modification. Newer, less invasive surgical and transcatheter techniques will expand interventional options. Summary Mitral valve abnormalities are a central pathological feature of HCM. Multimodality imaging is crucial for their identification and characterization prior to therapeutic intervention.

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Section: Mitral Valve Abnormalities In Hypertrophic Cardiomyopathymentioning

confidence: 99%