Echocardiographic mitral systolic motion in left ventricular aneurysm.

Greenwald, J G; Yap, Jiunn; Franklin, Meg; Lichtman, Alvin

doi:10.1136/hrt.37.7.684

Cited by 19 publications

(5 citation statements)

References 13 publications

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“…Isovolumic left ventricular shape changes have previously been studied angiographically, and have been described in normal subjects, and in patients with prolapsing mitral valve cusp (Gooch et al, 1972) or ischaemic heart disease. They have previously not been detected by echocardiography, though an abnormality of systolic mitral motion described by Greenwald et al (1975) may be explicable on the basis of mitral valve opening being late when compared with the onset of posterior movement of the mitral ring or posterior left ventricular wall.…”

Section: Discussionmentioning

confidence: 92%

Echocardiographic assessment of abnormal left ventricular relaxation in man.

Upton¹,

Gibson²,

Brown³

1976

Heart

114

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Frame-by-frame digitization of cineangiograms was used to confirm these findings which appear to reflect an abnormal change in left ventricular cavity shape during isovolumic relaxation.Although systolic abnormalities of left ventricular contraction have been well documented in ischaemic heart disease (Herman and Gorlin, 1969;Baxley and Reeves, 1971), only recently have diastolic abnormalities of left ventricular relaxation been noted. Within the past 4 years, several angiographic studies have described the onset of outward wall movement occurring before mitral valve opening (Ruttley et al., 1974;Altieri, Wilt, and Leighton, 1973;Hamby et al., 1974;Wilson et al., 1975), and the term segmental early relaxation phenomenon (SERP) has been used to describe this event. The diagnostic significance of these movements, however, is not clear since they were found whether or not ischaemic heart disease was present. The purpose of the present study was to see whether SERP could be detected by echocardiography in patients undergoing cardiac catheterization for the evaluation of chest pain, and to determine its relation, when present, to angiographic findings. In order to do this, echocardiograms of the anterior mitral valve leaflet and left ventricular cavity were recorded simultaneously at 100 mm/s, and a simple digitizing technique was used to compute instantaneous mitral valve velocity, left ventricular dimension, and its rate of change, so that the relation between mitral valve and wall movement in early diastole could be determined. Subjects and methods SubjectsEchocardiographic studies were performed on 64 patients who underwent cardiac catheterization for the evaluation of chest pain. Their ages ranged from 32 to 61, and 9 were women. All were in sinus rhythm and were studied within 24 hours of catheterization. They were selected only in so far as they were patients in whom it was possible to obtain acceptable echocardiographic records.They were divided according to the findings at

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Section: Discussionmentioning

confidence: 92%

Echocardiographic assessment of abnormal left ventricular relaxation in man.

Upton¹,

Gibson²,

Brown³

1976

Heart

114

View full text Add to dashboard Cite

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“…Another significant factor in the genesis of SAM may be the vigorous contraction of the LVPW (1,3,6,7,9,29). This vigorous contraction of the LVPW may occur as part of the generalized hyper contractile state as in volume overload of the left ventricle (aortic or mitral regurgitation) or as compensatory hypercontractility of the LVPW due to paradoxic septal motion as in atrial septal defect (7) or aneurysm of the anteroseptal wall of the left ventricle (8). Greenwald et al (8) observed SAM without ASH in patients with aneurysm of the left ventricular anterior wall and apex but not in a patient with aneurysm of the LVPW.…”

Section: Discussionmentioning

confidence: 99%

“…Recently Come et al (3) have proposed that the hypercontractile state of the left ventricular myocardium may be responsible for the production of SAM in the absence of ASH. Exaggerated left ventricular posterior wall (LVPW) motion has been implicated in the production of SAM in atrial septal defect (7) and in aneurysm of the left ventricular anterior wall (8). Gehrke and Goodwin (9) in a recent report have proposed that in patients with IHSS also, it is the vigorous LVPW motion that is responsible for SAM (9).…”

mentioning

confidence: 99%

“…ASH is the pathognomonic anatomic abnormality in IHSS while SAM has been correlated with the obstruction of the left ventricular outflow tract (LVOT) (12,32,33). SAM of the mitral valve by itself is not specific for the diagnosis of IHSS since SAM without ASH has been reported in atrial septal defect (7,35), aortic regurgitation (24), mitral valve prolapse (25), hypovolemic shock (1) and aneurysm of the left ventricular anterior wall (8).…”

mentioning

confidence: 99%

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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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“…M-mode echocardiographic studies have shown that SAM apparently involving the anterior mitral leaflet may occur in other conditions and, like asymmetric septal hypertrophy, does not appear to be specific to hypertrophic cardiomyopathy (Goodman er al., 1979;Greenwald et al, 1975;Nanda et al, 1975Nanda et al, , 1977Pearlman et al, 1979).…”

Section: Left Ventricular Outflow Obstructionmentioning

confidence: 99%

An evaluation of two‐dimensional echocardiography in the diagnosis of hypertrophic cardiomyopathy

Ballester¹,

Rees²,

Rickards³

et al. 1984

Clinical Cardiology

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Summary:Various anatomical and functional features of hypertrophic cardiomyopathy are analyzed in view of the data provided by two-dimensional echocardiography. Measurement of septal thickness is crucial, and is best done by a combination of M-Mode and 2-D echo. Two types of systolic anterior movement of the mitral valve (SAM) are observed and are related to the degree of subvalvular gradient. The specificity of these patterns of SAM is analyzed. The functional anatomy of the mitral valve in relation to the presence and degree of mitral regurgitation shows that although the presence and type of SAM are important, there are other causes of mitral regurgitation in hypertrophic cardiomyopathy unrelated to SAM. We emphasize the fact the 2-D echo cannot "diagnose" hypertrophic cardiomyopathy except when cardiac hypertrophy plus SAM involving the body of the mitral valve is seen; in the remaining cases, 2-D echo confirmshuggests the clinical diagnosis.

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Echocardiographic mitral systolic motion in left ventricular aneurysm.

Cited by 19 publications

References 13 publications

Echocardiographic assessment of abnormal left ventricular relaxation in man.

Echocardiographic assessment of abnormal left ventricular relaxation in man.

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

An evaluation of two‐dimensional echocardiography in the diagnosis of hypertrophic cardiomyopathy

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