It's not just the mitral valve - abnormal motion of the whole aorto-mitral apparatus occurs in both overt and subclinical hypertrophic cardiomyopathy
نویسندگان
چکیده
Background Mitral valve abnormalities are an important cause of patient morbidity in hypertrophic cardiomyopathy (HCM) contributing to left ventricular outflow tract obstruction (LVOTO). Anterior mitral valve leaflet (AMVL) elongation predisposes to LVOTO. CMR detects this in overt HCM and in sarcomere gene mutation carriers without left ventricular hypertrophy (G+LVH-). However, the geometry of the mitral valve, the subvalvular apparatus and the LVOT is more complex. The purpose of this study was analyse the whole aorto-mitral area (the aorto-mitral apparatus) and track its dynamic motion to explore mechanisms involved in LVOTO-predisposition in subclinical HCM.
منابع مشابه
Motion of mitral apparatus in hypertrophic cardiomyopathy with obstruction.
Motion of the mitral apparatus in hypertrophic cardiomyopathy with obstruction was investigated by conventional single dimensional and multidimensional echocardiography. In systole, anterosuperior displacement of the posterior papillary muscle, failure of mitral valve closure, and anterior motion of both mitral leaflets were shown. The anterior leaflet was seen to impinge on the posterior papil...
متن کاملAbnormal septal convexity into the left ventricle occurs in subclinical hypertrophic cardiomyopathy
BACKGROUND Sarcomeric gene mutations cause hypertrophic cardiomyopathy (HCM). In gene mutation carriers without left ventricular (LV) hypertrophy (G + LVH-), subclinical imaging biomarkers are recognized as predictors of overt HCM, consisting of anterior mitral valve leaflet elongation, myocardial crypts, hyperdynamic LV ejection fraction, and abnormal apical trabeculation. Reverse curvature of...
متن کاملSystolic anterior motion of the posterior mitral leaflet: a previously unrecognized cause of dynamic subaortic obstruction in patients with hypertrophic cardiomyopathy.
Dynamic obstruction to left ventricular outflow in patients with hypertrophic cardiomyopathy usually occurs when the anterior mitral leaflet moves forward in systole and approaches or contacts the ventricular septum. However, we have recently identified, by M mode and two-dimensional echocardiography, 21 patients with hypertrophic cardiomyopathy who had a unique pattern of mitral valve motion c...
متن کاملMechanism of systolic anterior motion of mitral valve and site of intraventricular pressure gradient in hypertrophic obstructive cardiomyopathy.
The mechanism of systolic anterior motion of the mitral valve and the localisation of the intraventricular pressure gradient were determined in 15 cases of hypertrophic obstructive cardiomyopathy by the combined use of real time two dimensional echocardiography and intracardiac manometry. We arrived at the following conclusions. The systolic anterior motion of the mitral echo in the M-mode echo...
متن کاملSustained improvement after combined anterior mitral valve leaflet retention plasty and septal myectomy in preventing systolic anterior motion in hypertrophic obstructive cardiomyopathy in children.
OBJECTIVE Anatomic alterations of the mitral valve such as increased mitral leaflet area, length and laxity, and anterior displacement of the papillary muscles in hypertrophic obstructive cardiomyopathy predispose patients to residual systolic anterior motion and persistence of outflow obstruction and mitral regurgitation after septal myectomy. We investigate the long-term results of combined a...
متن کامل