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Journal of Veterinary Internal Medicine 2007Papillary muscle hypertrophy can occur in conjunction with, or as the only indication of, hypertrophic cardiomyopathy or other diseases that result in left ventricular...
BACKGROUND
Papillary muscle hypertrophy can occur in conjunction with, or as the only indication of, hypertrophic cardiomyopathy or other diseases that result in left ventricular concentric hypertrophy (LVCH). Assessment of papillary muscle size is usually subjective because objective measures have not been reported.
HYPOTHESIS
The study hypothesis was that papillary muscle dimensions are different between normal cats and cats with LVCH.
ANIMALS
Echocardiograms from 44 normal cats and 40 cats with LVCH were included in the study.
METHODS
All measurements were taken from the right parasternal short-axis view at the level of the papillary muscles at end-diastole. Three methods were used to assess papillary muscle size: the area subtraction method, the direct area trace method, and the diameter method. Measurements were compared between cat groups and method comparisons were made among methods for area determination.
RESULTS
Cats with LVCH were older and had significantly greater left ventricular septal and free wall thicknesses and larger left atrial measurements than normal cats (P < .0006). Papillary muscle measurements were significantly greater by all measurement methods in cats with LVCH than in cats with normal echocardiograms (P < .0001). The area subtraction method and direct area trace method showed moderate agreement.
CONCLUSIONS AND CLINICAL IMPORTANCE
Papillary muscle measurements were larger for LVCH cats than normal cats; however, some overlap was present. The establishment of these objective measures adds to the echocardiographic examination of cats.
Topics: Animals; Cat Diseases; Cats; Echocardiography; Hypertrophy, Left Ventricular; Papillary Muscles
PubMed: 17708393
DOI: 10.1892/0891-6640(2007)21[737:pmmicw]2.0.co;2 -
PloS One 2018Functional mitral regurgitation (FMR) is a significant complication of left ventricle (LV) dysfunction associated with poor prognosis and commonly treated by undersized...
OBJECTIVES
Functional mitral regurgitation (FMR) is a significant complication of left ventricle (LV) dysfunction associated with poor prognosis and commonly treated by undersized ring annuloplasty. This study aimed to quantitatively simulate the treatment outcomes and mitral valve (MV) biomechanics following ring annulopalsty and papillary muscle relocation (PMR) procedures for a FMR patient.
METHODS
We utilized a validated finite element model of the left heart for a patient with severe FMR and LV dilation from our previous study and simulated virtual ring annuloplasty procedures with various sizes of Edwards Classic and GeoForm annuloplasty rings. The model included detailed geometries of the left ventricle, mitral valve, and chordae tendineae, and incorporated age- and gender- matched nonlinear, anisotropic hyperelastic tissue material properties, and simulated chordal tethering at diastole due to LV dilation.
RESULTS
Ring annuloplasty with either the Classic or GeoForm ring improved leaflet coaptation and increased the total leaflet closing force while increased posterior mitral leaflet (PML) stresses and strains. Classic rings resulted in larger coaptation forces and areas compared to GeoForm rings. The PMR procedure further improved the leaflet coaptation, decreased the PML stress and strain for both ring shapes and all sizes in this patient model.
CONCLUSIONS
This study demonstrated that a rigorously developed patient-specific computational model can provide useful insights into annuloplasty repair techniques for the treatment of FMR patients and could potentially serve as a tool to assist in pre-operative planning for MV repair surgical or interventional procedures.
Topics: Anisotropy; Chordae Tendineae; Finite Element Analysis; Heart Valve Prosthesis; Humans; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Models, Biological; Papillary Muscles
PubMed: 29902273
DOI: 10.1371/journal.pone.0198331 -
Journal of Ultrasound Mar 2018Hypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. The aim of this study was...
BACKGROUND
Hypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. The aim of this study was to evaluate the utility of three-dimensional echocardiography (3DE) for the geometric assessment of LV hypertrophy and PM morphology.
METHODS
The study included 24 patients with an established diagnosis of HC and 31 healthy controls. 3DE was performed using an iE33 or EPIQ 7C ultrasound system with an X5-1 transducer. QLAB software was used for the 3D analysis of LV wall thickness (LVWT) and PM morphology and hypertrophy; the number and cross-sectional area (CSA) of anterolateral and posteromedial PMs; and the presence of bifid or accessory PMs.
RESULTS
Patients with HC had a larger LVWT compared to controls in all segments (p < 0.001), and LVWT was largest in the midventricular septal segment (2.12 ± 0.68 cm). The maximum LVWT followed a spiral pattern from the LV base to the apex. The CSA of both anterolateral and posteromedial PMs was larger in patients with HC than in controls (1.92 vs. 1.15 cm; p = 0.001 and 1.46 vs. 1.08 cm; p = 0.033, respectively). The CSA of the posteromedial PM was larger in patients with LVOT obstruction than in those without (2.64 vs 1.16 cm, p = 0.021).
CONCLUSIONS
3DE allows the assessment of LV geometry and PM abnormalities in patients with HC. 3DE demonstrated that the maximum hypertrophy was variable and generally located in a spiral from the LV base to the apex.
Topics: Adult; Cardiomyopathy, Hypertrophic; Echocardiography, Three-Dimensional; Female; Heart Ventricles; Humans; Male; Organ Size; Papillary Muscles; Software
PubMed: 29374400
DOI: 10.1007/s40477-017-0277-y -
Clinical Cardiology Feb 1997The two left ventricular (LV) papillary muscles are small structures but are vital to mitral valve competence. Partial or complete rupture, complicating acute myocardial... (Review)
Review
The two left ventricular (LV) papillary muscles are small structures but are vital to mitral valve competence. Partial or complete rupture, complicating acute myocardial infarction, causes severe or even catastrophic mitral regurgitation, potentially correctable by surgery. Papillary muscle dysfunction is a controversial topic in that the role of the papillary muscle itself, in causing mitral regurgitation post infarction, has been seriously questioned; it is less confusing if this syndrome is attributed not only to papillary muscle but also to adjacent LV wall ischemia or infarction. Papillary muscle calcification is easily and frequently detected on echocardiography, but its clinical significance remains uncertain. Papillary muscle hypertrophy accompanies LV hypertrophy of varied etiology and may have a significant role in producing dynamic late-systolic intra-LV obstruction in hypertrophic cardiomyopathy and other hyperdynamic hypertrophied LV chambers. All the above abnormalities can be adequately assessed by 2-D echocardiography and the Doppler modalities. In selected cases, transesophageal echocardiography can provide additional valuable data by improving visualization of papillary muscles and mitral apparatus.
Topics: Cardiomyopathies; Echocardiography; Heart Ventricles; Humans; Mitral Valve; Papillary Muscles
PubMed: 9034636
DOI: 10.1002/clc.4960200203 -
Multimedia Manual of Cardiothoracic... Oct 2022We detail our technique for totally endoscopic, robotic-assisted mitral valve repair with the reimplantation of a ruptured papillary muscle head supported by double...
We detail our technique for totally endoscopic, robotic-assisted mitral valve repair with the reimplantation of a ruptured papillary muscle head supported by double papillary muscle relocation and mitral annuloplasty for the treatment of nonacute ischemic mitral regurgitation.
Topics: Humans; Papillary Muscles; Robotic Surgical Procedures; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Replantation
PubMed: 36314585
DOI: 10.1510/mmcts.2022.058 -
JACC. Cardiovascular Imaging Sep 2019
Topics: Cardiac Resynchronization Therapy; Heart Ventricles; Humans; Mitral Valve; Mitral Valve Insufficiency; Papillary Muscles
PubMed: 30660517
DOI: 10.1016/j.jcmg.2018.07.008 -
The Journal of Thoracic and... Jul 2018
Topics: Breakfast; Heart Neoplasms; Heart Ventricles; Humans; Lipoma; Papillary Muscles
PubMed: 29499869
DOI: 10.1016/j.jtcvs.2018.01.040 -
Journal of Clinical Pathology Nov 2006Reports of endodermal heterotopia (previously known as inclusion cysts) in cardiac atria are rare and there is only a single previous case report of endodermal... (Review)
Review
BACKGROUND
Reports of endodermal heterotopia (previously known as inclusion cysts) in cardiac atria are rare and there is only a single previous case report of endodermal heterotopia in a cardiac papillary muscle.
AIM AND METHODS
A cyst in a cardiac papillary muscle was identified during the autopsy of an 87-year-old man who had died from an unrelated myocardial infarction. The cyst was examined histologically and mucin staining and immunostaining were carried out.
RESULTS
We report a unilocular cyst in a cardiac papillary muscle, which is lined by low cuboidal, pseudostratified and occasionally ciliated respiratory-type epithelium, surrounded by a layer of smooth muscle. The immunohistochemical features (MNF116+, cytokeratin (CK)7+, CK8+, CK18+, CK19+, epithelial membrane antigen positive, scattered cells positive for neuroendocrine markers) suggest that this is an endodermal heterotopia. Immunostaining of positive thyroid transcription factor-1 provides evidence for bronchogenic differentiation.
DISCUSSION
The differential diagnoses of cystic structures in cardiac papillary muscle and the origin and importance of endodermal heterotopias are discussed.
Topics: Aged, 80 and over; Biomarkers; Bronchogenic Cyst; Cardiomyopathies; DNA-Binding Proteins; Diagnosis, Differential; Humans; Male; Papillary Muscles; Transcription Factors
PubMed: 17071807
DOI: 10.1136/jcp.2005.030312 -
British Heart Journal Sep 1977The anatomy of the papillary muscle of the conus, also known as Lancisi's muscle, was studied in 100 normal hearts from pathological collections and in 8 embryonic and...
The anatomy of the papillary muscle of the conus, also known as Lancisi's muscle, was studied in 100 normal hearts from pathological collections and in 8 embryonic and fetal hearts. Wide morphological variations were observed and because of this the name medial papillary complex is proposed. It is concluded that the value of this complex as an anatomical landmark in the right ventricle is a very restricted one. The development of the medial papillary complex is described.
Topics: Adolescent; Adult; Child; Child, Preschool; Fetal Heart; Heart; Humans; Infant; Middle Aged; Papillary Muscles
PubMed: 907765
DOI: 10.1136/hrt.39.9.1012 -
Anesthesiology Nov 1990The effect of ketamine (10(-5) and 10(-4) M) on the intrinsic contractility of left ventricular papillary muscle from normal hamsters and those with cardiomyopathy (BIO...
The effect of ketamine (10(-5) and 10(-4) M) on the intrinsic contractility of left ventricular papillary muscle from normal hamsters and those with cardiomyopathy (BIO 82.62, 6-month old) was investigated. At these concentrations, ketamine induced a positive inotropic effect on normal papillary muscle, as shown by an increase in maximum unloaded shortening velocity (+19 +/- 4 and +34 +/- 5%, P less than 0.05), active isometric force (+32 +/- 8 and +57 +/- 11%, P less than 0.05), and peak power output (+40 +/- 8 and +80 +/- 16%, P less than 0.05), and induced a slight decrease in sarcoplasmic reticulum function. Ketamine had no effect on the curvature of the total force-velocity curve, suggesting that it does not modify myothermal economy. Contractility of papillary muscle from hamsters with cardiomyopathy was less than that of controls, as shown by the decrease in isometric active force (-41%, P less than 0.02), peak power output (-33%, P less than 0.05), and sarcoplasmic reticulum function. The positive inotropic effect of ketamine on papillary muscle from hamsters with cardiomyopathy was less marked than in controls and almost suppressed in some cases: only the maximum unloaded shortening velocity was significantly increased with 10(-5) M ketamine (+7 +/- 6%, P less than 0.05), whereas no significant changes were observed in active isometric force (+14 +/- 8 and +13 +/- 11%; nonsignificant [NS]) and peak power output (+9 +/- 5 and +13 +/- 8%; NS) with ketamine (10(-5) and 10(-4) M, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Animals; Biomechanical Phenomena; Cardiomyopathies; Cricetinae; In Vitro Techniques; Ketamine; Mesocricetus; Muscle Relaxation; Myocardial Contraction; Papillary Muscles
PubMed: 2240681
DOI: 10.1097/00000542-199011000-00019