Diastolic mitral gradient without associated valvular stenosis: Usefulness of two‐dimensional echocardiography for a correct diagnosis

Perrenoud, Jean‐Jacques; Frangos, A.; Bopp, P

doi:10.1002/jcu.1870110204

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…A milestone was reached in 1982 when Foale et al characterized an LAA aneurysm using transthoracic echocardiography (TTE) [13]; by 1983, German literature was reporting LAA aneurysm characterization using echocardiography and computed tomography [14]. Meanwhile, other European researchers were exploring the value of echocardiography and tomography in diagnosing endocavitary thrombi [15], establishing a foundation for axial imaging use in diagnosing, characterizing, and surgically planning for these patients [2]. Finally, in 1990, Frambach et al and Comess et al reported two cases diagnosed using TTE and transesophageal echocardiography (TEE), respectively [2,16].…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Appendage Aneurysm: A Case Report and Literature Review

Ayala Torres,

Sepulveda Gallego,

Gonzalez Gonzalez

2024

Cureus

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The left atrial appendage aneurysm is an uncommon condition that has garnered attention from the medical community due to its low incidence and varied clinical manifestations. The difficulty in identification is reflected in its incidental detection in imaging studies such as echocardiograms and tomographies, while symptoms range from mild to severe, including heart failure and thromboembolic events. The complex etiology includes congenital and acquired factors, and its management focuses on preventing complications through surgical resection, accompanied by medical strategies such as controlling heart rhythm and anticoagulation. The case of a 67-year-old woman with significant medical history illustrates these challenges. Despite an inconclusive initial diagnosis, a tomography revealed an aneurysm with an intracavitary thrombus, leading to successful surgical resection. However, subsequent infectious complications resulted in her death. The average age of diagnosis is around 30 years, and while it is more common in women, there are no significant gender differences. Surgical management remains the preferred option, especially in severe cases, although in some patients, a watchful waiting approach is chosen. In conclusion, the left atrial appendage aneurysm is a complex entity that requires a multidisciplinary approach to improve clinical outcomes. Early diagnosis and appropriate treatment are crucial to prevent serious complications and improve the quality of life of affected patients.

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Section: Discussionmentioning

confidence: 99%

Left Atrial Appendage Aneurysm: A Case Report and Literature Review

Ayala Torres,

Sepulveda Gallego,

Gonzalez Gonzalez

2024

Cureus

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Noonan syndrome: A review

1985

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After an introduction dealing with the "historical evolution" of the Noonan syndrome (NS), we try to define the NS phenotype based on clinical descriptions published since 1883. The theories concerning the cause of the NS are discussed fully. The peculiar cardiac involvement deserves special attention and raises the question of whether the Watson and LEOPARD syndromes are indistinguishable from NS. Finally, the recent contributions to the variability of the NS phenotype (reports on lymphatic dysplasia, partial deficiency of factor XI, malignant hyperthermia, perceptual-motor disabilities, and endocrine evaluation) are also described.

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Bruch

Schmermund

Dagres

et al. 2002

The International Journal of Cardiac Imaging

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Significant mitral regurgitation (MR) may result from primary valve dysfunction or develop secondary to ischemic or dilated cardiomyopathy. The index 'isovolumic contraction time and isovolumic relaxation time divided by ejection time' (ICT + IRT/ET, 'Tei-index') is a well established measure of global cardiac function in patients with dilated cardiomyopathy and cardiac amyloidosis. We sought to define the diagnostic value of the Tei-index in patients with significant MR of various origin. Sixteen asymptomatic control subjects (8 male (m)/8 female (f), age 62+/-8 years, control group), 12 patients with primary MR (PMR) (mean grade 3.1+/-0.3, due to rupture of the chordae tendineae (n = 2), flail leaflet (n = 1), valve prolapse (n = 6) or rheumatic degeneration (n = 3), 6 m/6 f, age 58+/-18 years, NYHA class 2.5+/-0.3, PMR group) and 25 patients with secondary MR (SMR) (mean grade 3.1+/-0.3; due to ischemic (n = 14) or dilated cardiomyopathy (n = 10), 19 m/6 f, age 60+/-11 years, NYHA class 3.1+/-0.5, SMR group) underwent conventional two-dimensional (2D) and Doppler echocardiographic examination including measurement of the Tei-index. In the SMR group, left ventricular ejection fraction was reduced compared to the control and the PMR group (29+/-13% vs. 59+/-8% and 59+/-8%, p < 0.001 for both comparisons). The E/A ratio was elevated in PMR and SMR groups in comparison to the control group (1.74+/-0.44 and 1.70+/-0.45 vs. 1.09+/-0.28, p < 0.05). The Tei-index was easily and reproducibly measured in all study subjects. The mean value of the index was significantly elevated in the SMR group compared to control and PMR groups (0.87+/-0.3 vs. 0.42+/-0.07 and 0.38+/-0.05, p < 0.001). The difference between the control group and the PMR group did not reach statistical significance. In MR patients, receiver operating characteristic curve analysis for the Tei-index yielded an area under the curve of 0.96+/-0.03 for separating the PMR and the SMR group. Using a Tei-index > 0.51 as a cutpoint, SMR was identified with a sensitivity of 92% and a specificity of 88%. In MR patients, a significant correlation between left ventricular end-systolic volume and the Tei-index was observed (r = 0.71, p < 0.01). The Tei-index is a feasible and sensitive indicator of overall cardiac dysfunction in severely symptomatic patients with significant MR secondary to ischemic or dilated cardiomyopathy. The index is in the normal range in symptomatic patients with PMR and preserved systolic function. The Tei-index differentiates between patients with SMR and PMR and may be useful in the work-up of such patients.

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Diastolic mitral gradient without associated valvular stenosis: Usefulness of two‐dimensional echocardiography for a correct diagnosis

Cited by 3 publications

References 12 publications

Left Atrial Appendage Aneurysm: A Case Report and Literature Review

Left Atrial Appendage Aneurysm: A Case Report and Literature Review

Noonan syndrome: A review

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