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Systolic anterior motion

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https://www.readbyqxmd.com/read/29897435/mitral-valve-posterior-leaflet-reconstruction-using-extracellular-matrix-an-acute-porcine-study
#1
Marcell J Tjørnild, Søren N Skov, Karen B Poulsen, Mona Sharghbin, Leila L Benhassen, Lisa Carlson Hanse, Farhad Waziri, Diana M Røpcke, Sten L Nielsen, J Michael Hasenkam
OBJECTIVES: To investigate mitral valve posterior leaflet and subvalvular reconstruction using a 2-ply small intestinal submucosal extracellular matrix sheet. METHODS: Mitral valve posterior leaflet and subvalvular reconstruction was characterized in an acute 80-kg porcine model with 7 pigs acting as their own controls. The characterization was based on pressure catheter measurements of pressure differences to identify mitral regurgitation, stenosis and systolic anterior motion...
April 19, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29887442/numerical-simulation-study-on-systolic-anterior-motion-of-the-mitral-valve-in-hypertrophic-obstructive-cardiomyopathy
#2
Long Deng, Xueying Huang, Chun Yang, Bin Lyu, Fujian Duan, Dalin Tang, Yunhu Song
BACKGROUND: The hydrodynamic mechanisms of systolic anterior motion (SAM) of the mitral valve in hypertrophic obstructive cardiomyopathy (HOCM) remain unclear. METHODS: Based on computed tomography (CT) images and clinical data, pre- and post-operative computational models of the left ventricle were constructed for 6 HOCM patients receiving septal myectomy. SAM was abolished in 5 patients and persisted in one after septal myectomy surgery. The obtained simulation results including flow field of the left ventricle and mechanical behaviors of the mitral valve (MV) between pre- and post-operative FSI models were compared...
September 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29880372/hypertrophic-cardiomyopathy-in-liver-transplantation-patients
#3
S-L Pai, S Aniskevich, I I Logvinov, G V Matcha, W C Palmer, J L Blackshear
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disorder that presents with a hypertrophied nondilated left ventricle. In the absence of other known causes of cardiomyopathy, it is often associated with left ventricular outflow tract obstruction during systole, systolic anterior motion of the mitral valve, mitral regurgitation, and increased risk of sudden cardiac death. When HCM coexists with end-stage liver disease, it can be further complicated by cirrhosis-associated cardiovascular abnormalities, including hyperdynamic circulation, systolic and diastolic dysfunction, and electrophysiologic abnormalities...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29866348/definition-of-the-margin-of-major-coronary-artery-bifurcations-during-radiotherapy-with-electrocardiograph-gated-4d-ct
#4
Qian Li, Ying Tong, Yong Yin, Pinjing Cheng, Guanzhong Gong
PURPOSE: The aim was to measure the cardiac motion-induced displacements of major coronary artery bifurcations utilizing electrocardiography (ECG)-gated four-dimensional computed tomography (4D-CT) and to determine the margin of coronary artery bifurcations. METHODS: Thirty-seven female patients who underwent retrospective ECG-gated 4D-CT in inspiratory breath hold (IBH) were enrolled. The left main coronary artery bifurcation (LM), the obtuse marginal branch bifurcation (OM), the first diagonal branch bifurcation (D1 ), the second diagonal branch bifurcation (D2 ), the caudal portion of the left anterior descending branch (APX), the first right ventricular artery bifurcation (V) and the acute marginal branch bifurcation (AM) were contoured...
May 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29850268/postural-tachycardia-syndrome-and-vasovagal-syncope-a-hidden-case-of-obstructive-cardiomyopathy-without-severe-septal-hypertrophy
#5
Kenneth A Mayuga, Natalie Ho, Robert W Shields, Paul Cremer, L Leonardo Rodriguez
A 36-year-old female with symptoms of orthostatic intolerance and syncope was diagnosed with vasovagal syncope on a tilt table test and with postural tachycardia syndrome (POTS) after a repeat tilt table test. However, an echocardiogram at our institution revealed obstructive cardiomyopathy without severe septal hypertrophy, with a striking increase in left ventricular outflow tract gradient from 7 mmHg at rest to 75 mmHg during Valsalva, with a septal thickness of only 1.3 cm. Cardiac MRI showed an apically displaced multiheaded posteromedial papillary muscle with suggestion of aberrant chordal attachments to the anterior mitral leaflet contributing to systolic anterior motion of the mitral valve...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29849266/takotsubo-cardiomyopathy-presenting-as-wellens-syndrome
#6
R Scott Taylor, Leif Skjerli, John Ashurst
Takotsubo cardiomyopathy, also known as apical ballooning syndrome and stress cardiomyopathy, is a transient systolic and diastolic left ventricular dysfunction with a variety of cardiac wall-motion abnormalities that is increasingly being associated with significant morbidity and mortality. Wellens' syndrome is an electrocardiographic (ECG) pattern in a pain-free patient that is indicative of critical occlusion of the left anterior descending coronary artery requiring immediate cardiac catheterization. The authors report a case of a patient presenting with ECG findings consistent with Wellens' syndrome that was later found to have Takotsubo cardiomyopathy with angiographically normal coronary arteries on cardiac catheterization after a seizure...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29804797/tight-coronary-artery-stenosis-and-takotsubo-syndrome-triggered-each-other-well-illustrated-in-a-case
#7
Shams Y-Hassan
Post-ischemic myocardial stunning (PIMS) is defined as a prolonged and reversible left ventricular dysfunction induced by an acute coronary ischemic insult. Takotsubo syndrome (TS) is a recognized acute cardiac disease entity, characterized by a unique pattern of transient circumferential left ventricular wall motion abnormality (LVWMA). The LVWMA in TS has all the characteristic features of myocardial stunning. Herein, the case of a 76-year-old woman with severe three-vessel coronary artery disease presented with acute coronary syndrome inducing PIMS with features identical to mid-apical pattern of TS is reported...
May 16, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29743415/management-of-incomplete-initial-repair-in-the-treatment-of-degenerative-mitral-insufficiency
#8
Wenrui Ma, Wei Shi, Wei Zhang, Weihua Wu, Wei Ye, Ye Kong
We sought to present our institutional protocol to manage incomplete initial repair of degenerative mitral regurgitation and to evaluate its mid-term outcomes. Eight hundred and fifteen patients with degenerative mitral insufficiency undergoing mitral valve repair were investigated in this study. The initial repair attempt was incomplete in 48 patients, leaving a degree of residual regurgitation > mild, and an elevated transmitral gradient or systolic anterior motion (SAM). These patients were further treated with medication or mitral valve re-repair or replacement under reinstituted cardiopulmonary bypass...
May 9, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29706820/systolic-anterior-motion-of-the-mitral-valve-after-aortic-valve-replacement
#9
John F Zaki, Travis Markham, Warren Choi, Ovidiu Moise, Muaz Aijazi, Roy Sheinbaum
We present a case of severe systolic anterior motion developing intraoperatively after aortic valve replacement for aortic valve stenosis.
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29693944/unexpected-systolic-anterior-motion-of-the-mitral-valve-diagnosed-by-transthoracic-echocardiography-after-the-induction-of-general-anesthesia
#10
Toshiyuki Nakanishi, Manabu Yoshimura, Seishi Sakamoto, Takashi Toriumi
We report an 87-year-old woman who presented with unexpected systolic anterior motion (SAM) of the mitral valve after the induction of general anesthesia. She was receiving medication for hypertension and cerebral infarction. There were no abnormal findings on her preoperative transthoracic echocardiography (TTE) examination. After the induction of general anesthesia, she presented with refractory hypotension. We performed TTE and diagnosed SAM of the mitral valve. Her hemodynamic state was improved by fluid infusion and administering intravenous phenylephrine...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29667903/posterior-mitral-leaflet-plication-for-hypertrophic-obstructive-cardiomyopathy
#11
Praveen Kerala Varma, Neethu Krishna, Hisham Ahamed, Sujatha Madassery
Anomalies of the mitral valve apparatus in hypertrophic cardiomyopathy are an important cause of systolic anterior motion. Patients with significant residual obstruction due to systolic anterior motion after myectomy and anterior mitral leaflet plication may end up having mitral valve replacement. We describe the case of a 52-year-old man who underwent posterior mitral leaflet plication to correct residual systolic anterior motion after anterior mitral leaflet plication.
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29655822/clinical-spectrum-and-management-of-heart-failure-in-hypertrophic-cardiomyopathy
#12
REVIEW
Barry J Maron, Ethan J Rowin, James E Udelson, Martin S Maron
Heart failure (HF), characterized by excessive exertional dyspnea, is a common complication within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). HF has become an increasingly prominent management issue with the reduction in sudden deaths due to use of implantable defibrillators in this disease. Exertional dyspnea ranges in severity from mild to severe (New York Heart Association functional classes II to IV) and not uncommonly becomes refractory to medical management, leading to progressive disability, but largely in the absence of pulmonary congestion and volume overload requiring hospitalization...
May 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29642694/integrated-quadruple-stress-echocardiography
#13
Eugenio Picano, Doralisa Morrone, Maria C Scali, Alda Huqi, Katia Coviello, Quirino Ciampi
Stress Echocardiography (SE) is an established diagnostic technique. For 40 years, the cornerstone of the technique has been the detection of regional wall motion abnormalities (RWMA), due to the underlying physiologically-relevant epicardial coronary artery stenosis. In the last decade, three new parameters (more objective than RWMA) have shown the potential to integrate and comple- ment RWMA: 1- B-lines, also known as ultrasound lung comets, as a marker of extra-vascular lung water, measured using lung ultrasound with the 4-site simplified scan symmetrically of the antero- lateral thorax on the third intercostal space, from mid-axillary to anterior axillary and mid- clavicular line; 2-left ventricular contractile reserve (LVCR), assessed as the peak stress/rest ratio of left ventricular force, also known as elastance (systolic arterial pressure by cuff sphygmomanome- ter/end-systolic volume from 2D echocardiography); 3- coronary flow velocity reserve (CFVR) on left anterior descending coronary artery, calculated as peak stress/rest ratio of diastolic peak flow velocity assessed using pulsed-wave Doppler...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29616461/management-of-systolic-anterior-motion-of-the-mitral-valve-a-mechanism-based-approach
#14
REVIEW
Susumu Manabe, Hitoshi Kasegawa, Hirokuni Arai, Shuichiro Takanashi
Although the mechanism of systolic anterior motion (SAM) of the mitral valve is unknown, it is known to have a multifactorial pathophysiology. Echocardiographic analysis of the mitral leaflet revealed the step-wise progression of SAM, and intraventricular flow analysis revealed the contribution of drag force generated by the misled flow below the posterior leaflet. Although several diverse clinical features of SAM are already known, some key features need to be abstracted from among them to understand the regulation of SAM establishment...
April 3, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29602755/pathoanatomic-findings-and-treatment-during-hypertrophic-obstructive-cardiomyopathy-surgery-the-role-of-mitral-valve
#15
Giuseppe M Raffa, Giuseppe Romano, Marco Turrisi, Marco Morsolini, Giovanni Gentile, Sergio Sciacca, Alessandro Armaro, Vincenzo Stringi, Gabriella Mattiucci, Serena Magro, Fabiola Cosentino, Francesco Clemenza, Michele Pilato
BACKGROUND: To assess the role of the mitral valve apparatus (leaflets, chordae and papillary muscles, PM) in left ventricle outflow tract (LVOT) obstruction, and results of the surgical treatment for hypertrophic obstructive cardiomyopathy (HOCM). METHODS: Twenty-eight consecutive patients (58±11years, 53% female) undergoing HOCM surgery from 2007 to 2016 at our institute were retrospectively reviewed. Endpoints included the involvement of the mitral valve in LVOT obstruction, mortality, and changes in clinical and echocardiographic characteristics after HOCM surgery...
February 14, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29551091/evaluation-of-skeletal-muscle-microvascular-perfusion-of-lower-extremities-by-cardiovascular-magnetic-resonance-arterial-spin-labeling-blood-oxygenation-level-dependent-and-intravoxel-incoherent-motion-techniques
#16
Shiteng Suo, Lan Zhang, Hui Tang, Qihong Ni, Suqin Li, Haimin Mao, Xiangyu Liu, Shengyun He, Jianxun Qu, Qing Lu, Jianrong Xu
BACKGROUND: Noninvasive cardiovascular magnetic resonance (CMR) techniques including arterial spin labeling (ASL), blood oxygenation level-dependent (BOLD), and intravoxel incoherent motion (IVIM), are capable of measuring tissue perfusion-related parameters. We sought to evaluate and compare these three CMR techniques in characterizing skeletal muscle perfusion in lower extremities and to investigate their abilities to diagnose and assess the severity of peripheral arterial disease (PAD)...
March 19, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29549506/minimally-invasive-trans-mitral-septal-myectomy-for-diffuse-type-hypertrophic-obstructive-cardiomyopathy
#17
Taichi Sakaguchi, Toshinori Totsugawa, Kentaro Tamura, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka
OBJECTIVE: Despite excellent long-term results reported for a trans-aortic septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM), surgery for patients with diffuse hypertrophy is very challenging. In addition, a left ventricular outflow obstruction is often aggravated by an abnormal mitral valve and subvalvular apparatus. METHODS: We performed video-assisted minimally invasive trans-mitral septal myectomy procedures in 3 patients with diffuse-type HOCM, who were highly symptomatic despite maximal medical therapy...
March 16, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29547941/re-repair-of-the-failed-mitral-valve-insights-into-aetiology-and-surgical-management
#18
Gaby Aphram, Laurent De Kerchove, Stefano Mastrobuoni, Emiliano Navarra, Silvia Solari, Saadallah Tamer, Jerome Baert, Alain Poncelet, Jean Rubay, Parla Astarci, Philippe Noirhomme, Gebrine El Khoury
OBJECTIVES: Mitral valve (MV) repair is the gold standard for treatment of degenerative mitral regurgitation. A variety of surgical techniques allow surgeons to achieve a high rate of MV repair even with MV diseases of other aetiologies. However, a certain number of repairs fail over time. The aim of this study was to review our single-centre experience of MV re-repair and analyse the mode of repair failure, re-repair safety and efficiency in relation to the initial aetiology. METHODS: Between 1997 and 2015, 91 patients underwent redo MV re-repair...
March 14, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29536325/precision-of-regional-wall-motion-estimates-from-ultra-low-dose-cardiac-ct-using-squeez
#19
Amir Pourmorteza, Noemie Keller, Richard Chen, Albert Lardo, Henry Halperin, Marcus Y Chen, Elliot McVeigh
Resting regional wall motion abnormality (RWMA) has significant prognostic value beyond the findings of computed tomography (CT) coronary angiography. Stretch quantification of endocardial engraved zones (SQUEEZ) has been proposed as a measure of regional cardiac function. The purpose of the work reported here was to determine the effect of lowering the radiation dose on the precision of automatic SQUEEZ assessments of RWMA. Chronic myocardial infarction was created by a 2-h occlusion of the left anterior descending coronary artery in 10 swine (heart rates 80-100, ejection fraction 25-57%)...
March 13, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29531881/association-of-hypertrophic-obstructive-cardiomyopathy-with-rheumatoid-arthritis
#20
Mustafa Dawood, Noman Lateef, Abubakar Tauseef, Janki Patel
Our article refers to a 50-year-old woman with previously diagnosed rheumatoid arthritis (RA) who presented with symptoms of dyspnea on exertion and dizziness. An echocardiogram revealed a 17-mm asymmetric interventricular septum hypertrophy and systolic anterior motion of the anterior mitral valve leaflet. Association of hypertrophic obstructive cardiomyopathy (HCM) with connective tissue diseases has been well documented. For RA the human leukocyte antigen (HLA) system, particularly HLA-DR4, may possibly be a link between the two entities, as it is associated with both RA and HCM...
January 5, 2018: Curēus
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