Two dimensional echocardiography in mitral, aortic and tricuspid valve prolapse

Morganroth, Joel; Jones, Robert H.; Chen, Chin C.; Naito, Masahito

doi:10.1016/0002-9149(80)90287-8

Cited by 133 publications

(15 citation statements)

References 79 publications

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“…The examination was done according to current methods, 2-dimensional echocardiograms being taken in the parasternal and apical views. MVP was diagnosed according to the criteria of Morganroth et al 16 Bicuspid aortic valve was diagnosed when the commissures were well delineated and only two cusps were clearly recorded. 9 Intraventricular thrombi were diagnosed according to the cariteria of Asinger et al 1 ing 1 (3%).…”

Section: Methodsmentioning

confidence: 99%

“…Although the incidence of "abnormal echocardiograms" was similar in the two groups (56% and 54% respectively) the spectrum of abnormalities were different. 16 Echocardiographic findings appear to be of limited usefulness in the study of unselected stroke patients. 1012 The relationship between MVP and cerebral ischemic events, first suspected on the basis of anecdotal observations, 2 has been validated by a growing body of evidence.…”

Section: Frequency Of Echocardiographic Abnormalities In Patientsmentioning

confidence: 99%

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Frequency of echocardiographic abnormalities in patients with ischemia of the carotid territory--a preliminary report.

Gagliardi¹,

Benvenuti²,

Frosini³

et al. 1985

Stroke

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SUMMARY Eighty-eight consecutive patients referred to a neurosurgical Department (63 men and 25 women) aged from 14 to 68 years, with cerebral ischemia in the carotid territory were subjected to M-niode and two-dimensional echocardiography, carotid angiography and assessment of risk factors. There were 27 patients (average age 54 years) in whom carotid angiography demonstrated a probable source for the ischemia. Carotid angiography was normal in 51 of the remaining 61 (average age 39 years) while 10 revealed distant emboli. Although the incidence of "abnormal echocardiograms" was similar in the two groups (56% and 54% respectively) the spectrum of abnormalities were different. Only 5 (18%) of the 27 patients with abnormal angiograms had a potential cardiac source of emboli while 24 (39%) out of the remaining 61 patients had a potential cardiac source demonstrated at echocardiography. There was a high incidence of mitral valve prolapse (34%) in this latter group of patients. Mitral valve prolapse was not seen in the present series in patients with a probable carotid source on angiography.

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Section: Methodsmentioning

confidence: 99%

Section: Frequency Of Echocardiographic Abnormalities In Patientsmentioning

confidence: 99%

Frequency of echocardiographic abnormalities in patients with ischemia of the carotid territory--a preliminary report.

Gagliardi¹,

Benvenuti²,

Frosini³

et al. 1985

Stroke

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“…TTE examinations used the parasternal and apical acoustic windows. The diagnosis of MVP was made using the criteria proposed by Markiewicz et al" in the one-dimensional echocardiogram and by Morganroth et al 12 in the two-dimensional echocardiogram. The echocardiograms were recorded with a Panasonic video recorder and analyzed frame by frame using two independent observers who were not familiar with the patient's history.…”

Section: Echocardiographic Techniquementioning

confidence: 99%

Transesophageal two-dimensional echocardiography in young patients with cerebral ischemic events.

Zenker

Erbel

Mohr-Kahaly

et al. 1988

Stroke

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Using transesophageal echocardiography, cardiac structures can be imaged with high resolution. The aim of our study was to evaluate whether transesophageal echocardiography is superior in detecting mitral valve prolapse and other cardiac abnormalities compared with transthoracic echocardiography in an age-matched control group and in young patients with cerebral ischemic events (patient group). Forty patients with cerebral ischemic events (mean age 35.2 years) and 29 controls (mean age 30.4 years) were examined using both methods. Transthoracic and transesophageal echocardiography showed a significantly higher incidence of mitral valve prolapse in the patient group compared with the control group (p<0.001). By means of transesophageal echocardiography, it was possible to measure highly significant bulging in both the anterior and the posterior mitral leaflet in the patient group compared with the control group (p<0.001), and the thickness of the mitral leaflets was significantly higher in the patient group. In 9 of 20 (45%) patients with normal transthoracic echocardiograms, transesophageal echocardiography showed pathologic findings. We found transesophageal echocardiography to be a sensitive method for detecting mitral valve prolapse as well as valve changes and other cardiac abnormalities not detectable by conventional echocardiography. Our study underlines the role of mitral valve prolapse in young stroke patients as a relevant risk factor and emphasizes the importance of changed mitral valve morphology. {Stroke 1988;19:345-348)A series of studies has demonstrated an association of mitral valve prolapse (MVP) with cerebral ischemic events in younger patients.1 " 4 In 1980, Barnett and coworkers, by means of M-mode echocardiography, pointed out that the incidence of MVP in stroke patients <45 years of age was significantly higher (40%) than in age-matched controls.5 An increasing number of reports indicate that it is necessary to differentiate between "normal" MVP and a pathologic form with valve thickening and a high degree of myxomatous tissue change. 67 Some clinical retrospective studies address the possibility that the extent of valve involvement may influence the risk of embolic stroke. 8 -9 Transesophageal echocardiography (TEE) is a recently developed imaging technique with a very high degree of reliability and excellent resolution of the cardiac structures, especially the mitral valve.10 Until now, it has not been used for the cardiologic examination of younger patients with cerebral ischemic events.Our investigation examined whether TEE can provide additional diagnostic information in comparison with conventional transthoracic echocardiography ( r i b ) in patients with cerebral ischemic events and in Received March 14, 1987; accepted November 25, 1987. age-matched controls. In addition, we were also interested in analyzing the incidence of MVP by TEE, in quantifying the bulging of the mitral leaflets over the valve plane in normal and changed valves, and in performing measurements related to va...

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“…12 We have recently evaluated two young adults with unexplained cerebral infarction who illustrate this dilemma: one had definite auscultatory findings of MVP in the opinion of a senior cardiologist but had four M-mode and three 2-D echocardiograms that were normal; the other had no auscultatory findings, a normal 2-D echocardiogram, but MVP on M-mode echocardiography.…”

Section: Mitral Valve Prolapse and Cerebral Infarctionmentioning

confidence: 99%