Markedly abnormal mitral valve motion without simultaneous intraventricular pressure gradient due to uneven mitral-septal contact in idiopathic hypertrophic subaortic stenosis

King, James F.; DeMaria, Anthony N.; Miller, Richard R.; Hilliard, G.; Zelis, Robert; Mason, Dean T.

doi:10.1016/0002-9149(74)90040-x

Cited by 31 publications

(3 citation statements)

References 14 publications

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“…22 The mechanism of this phenomenon has not been completely explained. Nanda et al6 suggested a correlation between SAM of the mitral valve and left ventricular outflow obstruction in patients with TGA.…”

Section: The Mitral Valvementioning

confidence: 99%

Echocardiographic and hemodynamic correlation in transposition of the great arteries.

Park¹,

Neches²,

Zuberbuhler³

et al. 1978

Circulation

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Echocardiography was performed in 36 patients with transposition of the great arteries (TGA). Twenty patients were studied before a Mustard operation, 14 patients after operation and two patients both before and after operation. Right ventricular end-diastolic dimension (RVED) was larger than normal in each patient and tended to increase postoperatively. In contrast, the left ventricular end-diastolic dimension (LVED) was significantly reduced postoperatively in all patients. A linear relationship was demonstrated between the ratio of LVED/RVED and the ratio of peak systolic pressures in the left and right ventricles in studies both before and after Mustard operation. Systolic anterior motion of the mitral valve was observed in 18% of peroperative patients and increased to 44% postoperatively. The incidence of fluttering of the mitral valve increased from 50% to 94% after the operation. Abnormal septal motion was found in 39% of cases. Abnormal movement of the mitral valve and of the interventricular septum seems to be related to a reversed pressure relationship in the ventricles. Shifting of the ventricular septum toward the left ventricle and consequent distortion of the left ventricular cavity and mitral valve apparatus may be responsible for the abnormal echocardiographic findings. Serial echocardiographic studies may be useful as a noninvasive tool in the assessment of left ventricular pressure or the status of the pulmonary vascular bed in TGA.

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Section: The Mitral Valvementioning

confidence: 99%

Echocardiographic and hemodynamic correlation in transposition of the great arteries.

Park¹,

Neches²,

Zuberbuhler³

et al. 1978

Circulation

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“…SAM may or may not be associated with LVOT obstruction in IHSS (15,30). Whether SAM causes any LVOT obstruction in absence of ASH is not definitely known although such cases have been reported (4,20,21).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of SAM in IHSS has been correlated with the presence of hemodynamically significant LVOT obstruction and it has also been utilized in the assessment of medical and surgical therapy of IHSS (12,26,32,33). However, SAM may not always be associated with LVOT obstruction in IHSS (15). SAM without ASH has been reported in a wide variety of cardiac disorders and apparently normal individuals (3 , 4, 6 -8 , 21, 25,35).…”

Section: Discussionmentioning

confidence: 99%

Systolic Anterior Motion of the Mitral Valve with and without Asymmetric Septal Hypertrophy

Udoshi¹,

Shah²,

Fisher³

et al. 1980

Cardiology

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Abnormal systolic anterior (SAM) motion of the mitral valve without asymmetric hypertrophy of the interventricular septum was observed in 16 patients (group 1). 5 of the 16 patients had no other evidence of heart disease and the remaining 11 had a variety of cardiac disorders. Left ventricular dimensions, septal and posterior wall thickness, left ventricular ejection fraction, the mean velocity of circumferential fiber shortening, and the mean velocity of the posterior wall and septal contraction were measured by echocardiography in all patients in group 1. These measurements were compared with similar measurements in 14 patients with idiopathic hypertrophic subaortic stenosis (group 2) and in 11 normal subjects (group 3) to evaluate the role of the left ventricular contractility with particular reference to the left ventricular posterior wall motion in production of SAM. All patients with SAM (groups 1 and 2) showed significantly higher indexes of left ventricular contractility, particularly posterior wall velocity, and normalized mean posterior wall velocity, when compared to the normal subjects. The significantly higher posterior wall and the normalized mean posterior wall velocities in all patients with SAM suggest that the exaggerated systolic anterior motion of the left ventricular posterior wall plays an important role in production of SAM in the presence or absence of asymmetric septal hypertrophy.

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Idiopathic hypertrophic subaortic stenosis and ventricular preexcitation

Kerin

Blonder

Wajszczuk

et al. 1979

Cathet. Cardiovasc. Diagn.

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Two patients who had idiopathic hypertrophic subaortic stenosis (IHSS) and type A ventricular preexcitation were studied and showed variations of the subvalvular flow gradients. The increase in subvalvular gradient, occurring at a time when preexcitation developed, was associated with significant increase of the systolic murmur and the systolic anterior motion of the mitral valve. In patient 1, the significant increase in subvalvular gradient during ventricular preexcitation was also confirmed by catheterization of the left side of the heart. The increase of the gradient with the development of the ventricular preexcitation was apparently due to decreased end-diastolic volume. The importance of ventricular volume considered as a variable affecting outflow tract gradient in idopathic hypertrophic subaortic stenosis is emphasized.

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Markedly abnormal mitral valve motion without simultaneous intraventricular pressure gradient due to uneven mitral-septal contact in idiopathic hypertrophic subaortic stenosis

Cited by 31 publications

References 14 publications

Echocardiographic and hemodynamic correlation in transposition of the great arteries.

Echocardiographic and hemodynamic correlation in transposition of the great arteries.

Systolic Anterior Motion of the Mitral Valve with and without Asymmetric Septal Hypertrophy

Idiopathic hypertrophic subaortic stenosis and ventricular preexcitation

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