Vector Flow Mapping in Obstructive Hypertrophic Cardiomyopathy to Assess the Relationship of Early Systolic Left Ventricular Flow and the Mitral Valve

Ro, Richard; Halpern, Dan; Sahn, David J.; Homel, Peter; Arabadjian, Milla; Lopresto, Charles; Sherrid, Mark V.

doi:10.1016/j.jacc.2014.04.090

Cited by 138 publications

(106 citation statements)

References 27 publications

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“…63 Elongation of the anterior leaflet, which occurs in patients with hypertrophic obstructive cardiomyopathy, or loss of annular dynamics and restricted leaflet motion, as seen in individuals with functional mitral regurgitation, might alter these vortical structures and impair efficient ventricular pumping. 64 Loss of normal vortical structures might also increase residual blood in the left ventricle between consecutive cardiac beats, and therefore increase diastolic filling pressures, cause adverse ventricular dilatation, and biological remodelling. 65 As flow‐based imaging to detect cardiac dysfunction emerges, the role of the mitral valve and its lesions in governing efficient ventricular pumping might be further revealed.…”

Section: Mitral Valve Structurementioning

confidence: 99%

“…183 The importance of structural abnormalities in the mitral valve in generating SAM was recognized after observations that SAM can be present without HCM; 9 and that SAM begins before LVOT flow acceleration. 64,184 Furthermore, isolated anterior and inward displacement of the papillary muscles combined with leaflet elongation, especially of the posterior leaflet, can lead to SAM, the degree of which is related to leaflet length, even in the absence of septal hypertrophy. 15,17,185–192 …”

Section: Mitral Valve In Hcmmentioning

confidence: 99%

“…15 This situation creates a long, slack distal residual leaflet portion interposed into the outflow stream at the beginning of ejection, so that ejection pushes this leaflet portion towards the septum (Figure 11). 64,184,185 Secondary systolic acceleration as SAM narrows the LVOT can further propagate SAM via the Venturi effect. 185,188 These findings explain why obstructive SAM can accompany modest septal hypertrophy when excessive or segmental leaflet elongation and papillary muscle malposition is present.…”

Section: Mitral Valve In Hcmmentioning

confidence: 99%

See 2 more Smart Citations

Mitral valve disease—morphology and mechanisms

Levine¹,

Hagège²,

Judge³

et al. 2015

Nat Rev Cardiol

319

254

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Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but—even in adult life—remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular–ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of mitral valve disease.

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Section: Mitral Valve Structurementioning

confidence: 99%

Section: Mitral Valve In Hcmmentioning

confidence: 99%

Section: Mitral Valve In Hcmmentioning

confidence: 99%

See 1 more Smart Citation

Mitral valve disease—morphology and mechanisms

Levine¹,

Hagège²,

Judge³

et al. 2015

Nat Rev Cardiol

319

254

View full text Add to dashboard Cite

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“…To produce a 2-D field, this technique assumes that the out-of-plane components are small. VFM is readily available in Hitachi scanners and has been tested in several clinical situations [114], [115], [116]. It has also been assessed in patients with echocardiographic data extracted from GE (General Electric Healthcare) Vivid scanners [117], [118], [119], [120].…”

Section: Color-doppler Based Vector Flow Mappingmentioning

confidence: 99%

Ultrasound Vector Flow Imaging: I: Sequential Systems

Jensen

Nikolov²,

et al. 2016

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

108

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Abstract-The paper gives a review of the most important methods for blood velocity vector flow imaging (VFI) for conventional, sequential data acquisition. This includes multibeam methods, speckle tracking, transverse oscillation, color flow mapping derived vector flow imaging, directional beamforming, and variants of these. The review covers both 2-D and 3-D velocity estimation and gives a historical perspective on the development along with a summary of various vector flow visualization algorithms. The current state-of-the-art is explained along with an overview of clinical studies conducted and methods for presenting and using VFI. A number of examples of VFI images are presented, and the current limitations and potential solutions are discussed.

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“…и соавт., границей нормы площади митрального кла-пана является показатель 12 см 2 [26]. Известно, что у пациентов с ГКМП длина митраль-ных створок больше, чем у здоровых субъектов [27]. В ряде публикаций демонстрируют, что избыточная длина передней створки является независимым пре-диктором обструкции выходного тракта левого же-лудочка [17,28].…”

Section: б) избыточная длина передней створки митрального клапанаunclassified

Alcohol septal ablation: patient selection and rationality of its application

Kashtanov¹,

Chernyshev²,

Kardapoltsev³

et al. 2017

PKiK

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The article looks at some aspects of selecting patients with obstructive hypertrophic cardiomyopathy for alcohol septal ablation (ASA) procedure. Based on the world’s experience and in the context of evidence-based medicine, the current positions of ASA in complex treatment of obstructive hypertrophic cardiomyopathy are described. Received 29 September 2016. Accepted 9 January 2017.Funding: The study had no sponsorship.Conflict of interest: The authors declare no conflict of interest.Author contributionsData collection and analysis: Kashtanov M.G. Drafting the article: Kashtanov M.G. Critical revision: Kashtanov M.G., Idov E.M., Chernyshev S.D., Kardapoltsev L.V., Berdnikov S.V.

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Vector Flow Mapping in Obstructive Hypertrophic Cardiomyopathy to Assess the Relationship of Early Systolic Left Ventricular Flow and the Mitral Valve

Abstract: Early systolic flow impacts the posterior surfaces of protruding MVL initiating SAM in obstructive HCM.

Cited by 138 publications

References 27 publications

Mitral valve disease—morphology and mechanisms

Mitral valve disease—morphology and mechanisms

Ultrasound Vector Flow Imaging: I: Sequential Systems

Alcohol septal ablation: patient selection and rationality of its application

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