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Journal of the American College of... Jan 1988The purpose of this study was to prospectively determine the incidence of diastolic mitral and tricuspid regurgitation in atrioventricular (AV) block using Doppler...
Diastolic mitral and tricuspid regurgitation by Doppler echocardiography in patients with atrioventricular block: new insight into the mechanism of atrioventricular valve closure.
The purpose of this study was to prospectively determine the incidence of diastolic mitral and tricuspid regurgitation in atrioventricular (AV) block using Doppler echocardiography. The temporal relation between mitral and tricuspid diastolic insufficiency and the diastolic murmur recorded in patients with complete heart block was also investigated. Twenty-two consecutive patients with AV block (referred to the Echo-Doppler laboratory for routine clinical studies), aged 18 to 87 years, were enrolled in the study. Eleven patients had third degree AV block and a ventricular-inhibited (VVI) pacemaker, two patients had second degree AV block, seven patients had first degree AV block, one patient had blocked premature atrial complexes and one patient had atrial flutter with 4:1 AV block. Diastolic mitral regurgitation was detected in 20 patients, and diastolic tricuspid regurgitation in 21. A mid-diastolic murmur was detected in all patients except in the three youngest. The murmur occurred before diastolic regurgitation and coincided with peak forward flow through the AV valve after atrial contraction. M-mode mitral valve echocardiograms obtained in nine patients demonstrated near closure of some portions of the mitral valve after atrial contraction. Effective closure of the valve, however, did not occur unless ventricular systole supervened. In conclusion, diastolic mitral and tricuspid regurgitation are almost universally present in patients with AV block and are associated with a diastolic murmur. The murmur coincides with forward AV valve flow. Diastolic regurgitation is silent. Effective AV valve closure is not established until ventricular systole occurs, as demonstrated by M-mode echocardiographic recording of the mitral valve.
Topics: Adult; Aged; Aged, 80 and over; Diastole; Echocardiography; Electrocardiography; Female; Heart Block; Heart Murmurs; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Time Factors; Tricuspid Valve; Tricuspid Valve Insufficiency
PubMed: 3335709
DOI: 10.1016/0735-1097(88)90170-2 -
Medicine Aug 2022We have aimed at exposing left ventricular diastolic functions and the presence of known genetic mutations for familial erythrocytosis, in patients who exhibit...
BACKGROUND
We have aimed at exposing left ventricular diastolic functions and the presence of known genetic mutations for familial erythrocytosis, in patients who exhibit idiopathic erythrocytosis.
METHODS
Sixty-four patients with idiopathic erythrocytosis (mean age, 46.4 ± 2.7 years) and 30 age-matched healthy subjects were prospectively evaluated. The regions of interest of the erythropoietin receptor, hemoglobin beta-globin, von Hippel-Lindau, hypoxia-inducible factor 2 alpha, and Egl-9 family hypoxia-inducible factor genes were amplified by PCR. Left ventricular (LV) mass was measured by M-mode and 2-dimensional echocardiography. LV diastolic functions were assessed by conventional echocardiography and tissue Doppler imaging.
RESULTS
As a result of genetic analyses, genetic mutations for familial erythrocytosis were detected in 5 patients. It has been observed in our study that the risk of cardiovascular disorders is higher in patients. Interventricular septum thickness, left atrial diameter, and some diastolic function parameters such as deceleration time and isovolumetric relaxation time have been found to be significantly higher in idiopathic erythrocytosis group than in the controls.
CONCLUSION
This study has shown that LV diastolic functions were impaired in patients with idiopathic erythrocytosis. In this patient group with increased risk of cardiovascular disorders, the frequent genetic mutations have been detected in 5 patients only. Therefore, further clinical investigations are needed as novel genetic mutations may be discovered in patients with idiopathic erythrocytosis because of cardiovascular risk.
Topics: Adult; Case-Control Studies; Diastole; Heart Murmurs; Humans; Middle Aged; Mutation; Polycythemia; Ventricular Dysfunction, Left; Ventricular Function, Left
PubMed: 35960118
DOI: 10.1097/MD.0000000000029881 -
The Turkish Journal of Pediatrics 2019Yakut K, Varan B, Erdoğan İ. Asymptomatic giant congenital left atrial aneurysm. Turk J Pediatr 2019; 61: 117-119. Congenital aneurysm of the left atrial appendage can...
Yakut K, Varan B, Erdoğan İ. Asymptomatic giant congenital left atrial aneurysm. Turk J Pediatr 2019; 61: 117-119. Congenital aneurysm of the left atrial appendage can be caused by congenital dysplasia of the pectinate muscles and may be accompanied by a congenital absence of the pericardium. Symptoms generally manifest after two decades and the most common symptom is atrial arrhythmia in the form of atrial fibrillation / flutter. A four year-old patient with no symptoms underwent an echocardiographic examination for the investigation of a heart murmur. Echocardiographic examination revealed a large cystic lesion occupying the left hemithorax and compressing the left ventricle. The patient was referred to our center. The lesion caused displacement of the heart rightward behind the sternum which made the examination difficult. We aimed to present this rare case of giant left atrial appendage aneurysm in the light of current literature.
Topics: Asymptomatic Diseases; Atrial Appendage; Child, Preschool; Heart Aneurysm; Heart Murmurs; Humans; Magnetic Resonance Angiography; Male; Radiography
PubMed: 31559732
DOI: 10.24953/turkjped.2019.01.019 -
Journal of the American Veterinary... Jun 2009To determine the prevalence of cardiomyopathy and the relationship between cardiomyopathy and heart murmurs in apparently healthy cats.
OBJECTIVE
To determine the prevalence of cardiomyopathy and the relationship between cardiomyopathy and heart murmurs in apparently healthy cats.
DESIGN
Cross-sectional study.
ANIMALS
103 privately owned, apparently healthy domestic cats.
PROCEDURES
Cats were physically and echocardiographically examined by 2 investigators independently. Left ventricular wall thickness was determined via 2-dimensional echocardiography in short-axis and long-axis planes. Left ventricular hypertrophy was identified when end-diastolic measurements of the interventricular septum or posterior wall were > or = 6 mm. Cats with left ventricular hypertrophy but without left ventricular dilatation were considered to have hypertrophic cardiomyopathy (HCM). The associations between heart murmurs and Doppler echocardiographic velocity profiles indicative of dynamic ventricular outflow tract obstruction were evaluated.
RESULTS
Heart murmurs were detected in 16 (15.5%; 95% confidence interval, 9.2% to 24.0%) cats; of these, 5 had cardiomyopathy. Cardiomyopathy was also identified in 16 (15.5%; 95% confidence interval, 9.2% to 24.0%) cats; 15 had HCM, and 1 had arrhythmogenic right ventricular cardiomyopathy. Of the cats with HCM, 11 had segmental left ventricular hypertrophy, 3 had diffuse left ventricular hypertrophy, and 1 had borderline left ventricular hypertrophy with marked systolic anterior motion of the mitral valve. Sensitivity and specificity of auscultatory detection of a heart murmur for diagnosing cardiomyopathy were 31% and 87%, respectively. Echocardiographic evidence of late systolic acceleration within ventricular outflow tracts was associated with the existence of a heart murmur.
CONCLUSIONS AND CLINICAL RELEVANCE
Cardiomyopathy was common in the healthy cats evaluated in this study. In apparently healthy cats, detection of a heart murmur is not a reliable indicator of cardiomyopathy.
Topics: Animals; Cardiomyopathies; Cat Diseases; Cats; Echocardiography; Female; Heart Murmurs; Male; Prevalence
PubMed: 19480619
DOI: 10.2460/javma.234.11.1398 -
Annals of Medicine and Surgery (2012) Aug 2022Valvular heart disease is highly prevalent, especially in developing countries. Mitral Stenosis (MS) is a condition where there is narrowing of mitral heart valve. Left...
INTRODUCTION
Valvular heart disease is highly prevalent, especially in developing countries. Mitral Stenosis (MS) is a condition where there is narrowing of mitral heart valve. Left atrial (LA) thrombus is often seen in severe MS patients.
CASE PRESENTATION
A 47-year-old woman complained of palpitation and shortness of breath. The heart sounded irregularly irregular, with grade III/IV diastolic murmurs at the apex. Her electrocardiogram showed atrial fibrillation (AF) with rapid ventricular response Transthoracal echocardiography (TTE) showed severe MS, mild tricuspid regurgitation, and LA thrombus. Mitral valve replacement surgery, tricuspid valve repair, and evacuation of the LA thrombus were immediately done. We evacuated a spherical mass with a size of 4 × 3x2.2 cm, layered and easily separated. Microscopic examination showed extensive fibrin and bleeding with mononuclear inflammatory cells and macrophages, corresponding to a thrombus conclusion.
CLINICAL DISCUSSION
Atrial thrombus is common in MS patients. The incidence will increase by about two times in patients with AF. TTE is a reliable tool in diagnosing large mobile atrial thrombus and differentiated it from other cardiac masses. However, histopathological examination is still the gold standard to distinguish between LA thrombus and myxoma. Immediate thrombus evacuation and valve replacement, if needed, will give good results and reduce systemic thromboembolism.
CONCLUSION
LA thrombus is often seen in a patient with severe MS. Optimal preoperative preparation involves assessing preoperative risk stratification will give good results.
PubMed: 36045842
DOI: 10.1016/j.amsu.2022.104328 -
Journal of Veterinary Cardiology : the... Apr 2023Systolic murmurs in the absence of cardiac structural abnormalities are common in cats. Narrow aorto-septal angle (AoSA) and septal remodeling can be a cause of a...
INTRODUCTION/OBJECTIVES
Systolic murmurs in the absence of cardiac structural abnormalities are common in cats. Narrow aorto-septal angle (AoSA) and septal remodeling can be a cause of a systolic murmur in elderly human beings. The aim of this study was to measure the AoSA in cats and to investigate the association between the AoSA and the presence of a murmur and isolated basal septal hypertrophy (IBSH).
ANIMALS
The study population comprised 122 cats.
MATERIALS AND METHODS
A physical exam, blood pressure measurement, chest radiographs, and echocardiography were performed.
RESULTS
A systolic murmur was audible in 39/122 cats. A difference between cats with and without a murmur was found for age (P=0.0001), interventricular basal septal thickness (BIVSd) (P=0.004), AoSA (P=0.003), aortic (P<0.0001), and pulmonic (P=0.021) flow velocity, the presence of IBSH (P<0.0001), and systolic anterior motion of the mitral valve (P=0.0002). More than 50% of cats with a murmur had an AoSA ≤122°. Less than 25% of the cats with an AoSA ≥137° had a murmur. The AoSA narrowed 0.55°/year of age (P<0.001), whereas the BIVSd increased 0.11 mm/year of age (P<0.0001); the BIVSd increased as the AoSA narrowed. In all cats with AoSA < 120°, IBSH was present.
CONCLUSIONS
This study demonstrates that the probability of having a systolic murmur in cats is increased by the presence of a narrow AoSA. Aging was associated with a narrower AoSA and a thicker basal septum; these findings might represent an age-related heart remodeling.
Topics: Humans; Cats; Animals; Systolic Murmurs; Echocardiography; Heart Murmurs; Ventricular Septum; Hypertrophy; Cat Diseases
PubMed: 37037177
DOI: 10.1016/j.jvc.2023.03.002 -
Heart (British Cardiac Society) Sep 2001
Review
Topics: Cardiomyopathy, Restrictive; Diagnosis, Differential; Electrocardiography; Heart Murmurs; Humans; Magnetic Resonance Angiography; Pericarditis, Constrictive; Ultrasonography, Doppler
PubMed: 11514495
DOI: 10.1136/heart.86.3.343 -
Acta Veterinaria Scandinavica Sep 2010A breeding program with the aim of reducing the prevalence of mitral regurgitation (MR) caused by myxomatous mitral valve disease (MMVD) in Cavalier King Charles...
A breeding program with the aim of reducing the prevalence of mitral regurgitation (MR) caused by myxomatous mitral valve disease (MMVD) in Cavalier King Charles Spaniels (CKCS) is currently ongoing in Sweden. In this investigation 353 CKCS were selected as a sample of the population and 150 were examined by auscultation for heart murmurs when they reached the age of six years in 2007 and 2009. The aim with this investigation was to study the prevalence of heart murmurs in six-year-old CKCS and to estimate if prevalence has decreased since the breeding program was introduced 2001. The effect of the breeding program was evaluated by comparing the prevalence of heart murmurs in the two groups. In 2007, the prevalence of heart murmurs was 52% (50% for females and 54% for males) and in 2009, the prevalence was 55% (44% for females and 67% for males). No significant difference was found in the prevalence of heart murmurs between 2007 and 2009 (P=0.8). For all six-year-old CKCS, the prevalence of heart murmur was 53% (females 46% and males 61%), which is higher than previous Swedish investigations.
Topics: Animals; Breeding; Dog Diseases; Dogs; Female; Heart Auscultation; Heart Murmurs; Logistic Models; Male; Mitral Valve Insufficiency; Prevalence; Sweden
PubMed: 20863375
DOI: 10.1186/1751-0147-52-54 -
Journal of the American Heart... Sep 2023Background Short-term effects on mitral valve (MV) anatomy after transcatheter edge-to-edge repair using the PASCAL system remain unknown. Precise quantification might...
Background Short-term effects on mitral valve (MV) anatomy after transcatheter edge-to-edge repair using the PASCAL system remain unknown. Precise quantification might allow for an advanced analysis of predictors for mean transmitral gradients. Methods and Results Consecutive patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation using PASCAL or MitraClip systems were included. Quantification of short-term MV changes throughout the cardiac cycle was performed using peri-interventional 3-dimensional MV images. Predictors for mean transmitral gradients were identified in univariable and multivariable regression analysis. Long-term results were described during 1-year follow-up. A total of 100 patients undergoing transcatheter edge-to-edge repair using PASCAL (n=50) or MitraClip systems (n=50) were included. Significant reductions of anterior-posterior diameter, annular circumference, and area throughout the cardiac cycle were found in both cohorts (<0.05 for all). Anatomic MV orifice area remained larger in the PASCAL cohort in mid (2.8±1.0 versus 2.4±0.9 cm; =0.049) and late diastole (2.7±1.1 versus 2.2±0.8 cm; =0.036) compared with the MitraClip cohort. Besides a device-specific profile of independent predictor of mean transmitral gradients, reduction of middiastolic anatomic MV orifice area was identified as an independent predictor in both the PASCAL (=-0.410; =0.001) and MitraClip cohorts (=-0.318; =0.028). At follow-up, reduction of mitral regurgitation grade to mild or less was more durable in the PASCAL cohort (90% versus 72%; =0.035). Conclusions PASCAL and MitraClip showed comparable short-term effects on MV geometry. However, PASCAL might better preserve MV function and demonstrated more durable mitral regurgitation reduction during follow-up. Identification of independent predictors for mean transmitral gradients might potentially help to guide device selection in the future.
Topics: Humans; Heart Murmurs; Mitral Valve; Mitral Valve Insufficiency
PubMed: 37646220
DOI: 10.1161/JAHA.123.030333 -
American Family Physician Mar 2022
Topics: Child; Heart Auscultation; Heart Murmurs; Humans; Parents
PubMed: 35289586
DOI: No ID Found