Diagnosis and evaluation of mitral valve disease using transseptal Doppler ultrasound catheterization.

Kalmanson, D; Veyrat, C; Bernier, Angelina; Savier, C; Chiche, P; Witchitz, S

doi:10.1136/hrt.37.3.257

Cited by 17 publications

(9 citation statements)

References 2 publications

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“…It is, therefore, difficult to conceive how augmentation of 'M' could be accounted for by postulating an increase in the velocity of flow through a diminishing orifice when there has been insignificant travel of the ball from the apex to the base of the prosthesis. Using a transseptal Doppler ultrasound technique, Kalmanson et al (1975) have shown that the velocity of blood flow across the mitral valve is decreasing at this time.…”

Section: Resultsmentioning

confidence: 99%

Non-invasive observations on initial low frequency vibrations of the first heart sound--correlation with the 'presystolic' murmur in mitral stenosis.

Armstrong¹,

Mitha²,

Matisonn³

et al. 1978

Heart

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SUMMARYThe initial low frequency component of the first heart sound, 'M', has been studied in normal subjects, and in patients with various prosthetic mitral valves and with mitral stenosis, using simultaneous low frequency phonocardiography, echocardiography, and apex cardiography. These techniques showed 'M' to have a constant morphology in preisovolumic systole. In mitral stenosis, 'M' and the preisovolumic 'presystolic' murmur appear to be the same phonocardiographic phenomenon. While 'M' was present in sinus rhythm, augmentation of this normal vibration occurred particularly during the short cycles of atrial fibrillation. Leaflet coaption and movement of the ventricular wall as detected echocardiographically do not appear to play a role in its pathogenesis but the sound could emanate from the ventricular wall as it tautens and decreases its compliance at the onset of systole.The initial low frequency component of the first heart sound has been studied for more than 150 years (Orias, 1936;Eckstein, 1937;Smith et al., 1941;Lakier et al., 1970;Luisada and Argano, 1971;Lakier et al., 1972a, b;Armstrong and Gotsman, 1973). We hope to show that the sound is more than just an abstruse phonocardiographic finding but has clinical significance in that it is responsible for the short crescendo, so-called 'presystolic', murmur of mitral stenosis in atrial fibrillation, as suggested by Tavel and Bonner (Bonner et al., 1976;Tavel and Bonner, 1976). This sound, which occurs near the peak of the R wave of the electrocardiogram and at the crossover point of the left atrial and ventricular pressures, has been termed 'M' by Lakier et al. (1970) and '0' by Luisada and Argano (1971) (Fig. 1). In contrast, the later higher frequency component of the first heart sound (Ml) occurs at the time of the left atrial C wave (Lakier et al., 1972a, b).The cause of 'M' remains controversial. The sound has been attributed to initial coaption of the mitral valve leaflets and the sound 'Ml' to subsequent tensing of the mitral cusps and chordae

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Section: Resultsmentioning

confidence: 99%

Non-invasive observations on initial low frequency vibrations of the first heart sound--correlation with the 'presystolic' murmur in mitral stenosis.

Armstrong¹,

Mitha²,

Matisonn³

et al. 1978

Heart

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“…Figure 2A) mais pour la valvule mitrale, la voie transseptale adoptée nous a obligés à modifier la tête en bout de cathéter pour traverser la paroi septale en la rendant orientable pour s'adapter à sa configuration (VUS 185, Figure 2B). Les courbes chez l'homme normal et pathologique ont succédé aux tracés expérimentaux [11][12][13][14][15]. (Figure 1 A).…”

Section: Cb : Votre Dernier Article Paru En Mai 2015 [2] Figure Danunclassified

“…À droite, schéma de la courbe de vélocité instantanée du flux mitral : aux mêmes critères morphologiques qu'à droite s'associent des critères chronologiques rigoureux et spécifiques représentés pour chaque composante des courbes par rapport aux différentes phases du cycle cardiaque y compris les plus minimes, tels la contraction isovolumique, la relaxation ou les mouvements valvulaires. ci: contraction isométrique ; mo : ouverture mitrale ; S : onde systolique ; D : onde protodiastolique de remplissage rapide (la dénomination E pour échographie, a été adoptée ultérieurement) ; A : onde présystolique liée à la contraction auriculaire ; ECG : électrocardiogramme ; PCG : phonocardiogramme ; S1, S2, S3, S4 : bruits du coeur ; LA, LV : oreillette et ventricule gauches ; MFV : mitral flow velocity (reproduit d'après [11] et [15] Figure 3B). Il n'y avait plus qu'à travailler !…”

Section: Cb : Votre Dernier Article Paru En Mai 2015 [2] Figure Danunclassified

Une histoire de la recherche clinique en cardiologie

Veyrat¹,

Bruel²

2016

Med Sci (Paris)

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Il y a moins de cinquante ans, la détection par l’effet Doppler des sens antéro- et rétrogrades du courant sanguin appliquée à l’étude des flux cardiaques a été rendue possible par une petite équipe confidentielle, constituée en majeure partie de cardiologues cliniciens. Elle a révolutionné l’approche de la physiopathologie cardiovasculaire et imposé une nouvelle méthodologie d’examen répandue dans le monde entier. Sous la forme d’un entretien réalisé par le Dr Christiane Bruel, médecin général de santé publique, le Docteur Colette Veyrat, cardiologue, chargé de recherches honoraire au CNRS, ex-directeur du laboratoire d’Écho-Doppler, service de cardiologie de l’Hôpital Bicêtre, se souvient…

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“…(2) This is not true in diseased valves, whose velocity profiles are irregular and asymmetrical (Kalmanson et al, 1975b;Whamond and Taylor, 1976). This stresses the necessity for carefully exploring the various sites of the mitral annulus, lest one type of lesion is overlooked.…”

Section: Effect Of Velocity Profilesmentioning

confidence: 99%

Non-invasive recording of mitral valve flow velocity patterns using pulsed Doppler echocardiography. Application to diagnosis and evaluation of mitral valve disease.

Kalmanson¹,

Veyrat²,

Bouchareine³

et al. 1977

Heart

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A new technique using pulsed Doppler echocardiography for non-invasive recording of blood flow velocity patterns at the site of the mitral annulus is described. In a control group of 30 subjects in whom an organic or functional lesion of the mitral valve had been ruled out, the normal flow velocity pattern was found to be similar to that obtained either experimentally by other authors using an implanted electromagnetic cuff flowmeter or clinically by our group using the transseptal catheterisation continuous wave Doppler technique. In 31 patients with confirmed mitral valve disease, the mitral valveflow velocity patterns were correlated with the clinical and haemodynamic data, and in 10 cases the patterns were compared with the flow velocity curves recorded in the same patients using the Doppler ultrasonic transseptal catheterisation of the mitral valve. In most cases, characteristic anomalies of these patterns were noted and could be related to the type of the lesion, stenosis, regurgitation, or a combination of these.Specific patterns of mitral valve flow velocity profiles were shown to correlate satisfactorily with the degree of the lesion, with some reservations for mitral regurgitation. Though not fully quantitative, the pulsed Doppler technique is a new and promising non-invasive methodfor establishing the diagnosis of mitral stenosis and/or regurgitation, and to some extent, grading the severity of mitral valve disease using pattern recognition. It provides an original approach to the understanding of mitral haemodynamic disturbances on a beat-to-beat basis.The paramount importance of the knowledge of instantaneous transmitral blood flow for our understanding of/and our ability to diagnose accurately mitral valve disease has been recently stressed (Kalmanson, 1976). We have previously shown the diagnostic use of continuous wave Doppler ultrasonic transseptal catheterisation of the mitral valve for such purposes (Kalmanson et al., 1975a, b). Unfortunately, the cumbersome and traumatic nature of such a procedure somewhat restricts its routine application in clinical cardiology and therefore led us to search for a non-invasive technique for investigating mitral valve flow.In 1973 S.).Received for publication 6 September 1976 blood flow using the combined transcutaneous pulsed Doppler and conventional echocardiographic procedures. At our request, the audio frequency output signal of the pulsed Doppler was demodulated by means of a frequency-to-voltage converter and a single continuous curve was thus substituted for the frequency spectral display previously necessary to interpret the output signal. A new method was devised and tested by our group for recording blood flow velocity patterns from the heart valves. The encouraging results are presented here. Subjects and methodsWe first studied a control group of 30 subjects, 13 women and 17 men, ranging in age from 7 to 40 years, all with normal hearts or in whom organic or 517 on 11 May 2018 by guest. Protected by copyright.

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Diagnosis and evaluation of mitral valve disease using transseptal Doppler ultrasound catheterization.

Cited by 17 publications

References 2 publications

Non-invasive observations on initial low frequency vibrations of the first heart sound--correlation with the 'presystolic' murmur in mitral stenosis.

Non-invasive observations on initial low frequency vibrations of the first heart sound--correlation with the 'presystolic' murmur in mitral stenosis.

Une histoire de la recherche clinique en cardiologie

Non-invasive recording of mitral valve flow velocity patterns using pulsed Doppler echocardiography. Application to diagnosis and evaluation of mitral valve disease.

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