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. 1975 Dec;37(12):1286–1302. doi: 10.1136/hrt.37.12.1286

Echocardiographic spectrum of hypertrophic cardiomyopathy.

O Feizi, R Emanuel
PMCID: PMC482955  PMID: 131564

Abstract

Echocardiographic patterns in 15 patients with hypertrophic cardiomyopathy were compared with those in 30 healthy persons. Correlations with angiocardiographic data indicated that most of the anatomical abnormalities in hypertrophic cardiomyopathy can be assessed reliably by echocardiography. These include abnormal mitral valve motion, a reduction of the anteroposterior dimension of the left ventricular outflow tract and of the left and right ventricular cavities, increased thickness of the interventricular septum and the posterior left ventricular wall. Comparision of the haemodynamic and echocardiographic data showed that some degree of abnormal mitral valve motion during systole may occur in the absence of left ventricular outflow tract obstruction. On the other hand, it need not always be present with left ventricular outflow tract obstruction. Other, hitherto unrecognized, abnormalities in hypertrophic cardiomyopathy detected by this technique were: (1) Aortic valve regurgitation in three out of nine patients with evidence of left ventricular cutflow tract obstruction at cardiac catheterization. (2) Left ventricular inflow tract obstruction at the mitral valve level associated with gross septal hypertrophy (five cases). (3) Abnormal forward displacement of the posterior mitral valve leaflet and of the chordae tendineae during systole in 10 patients, in seven of whom there was confirmatory angiocardiographic evidence. Seven patients with miscellaneous cardiac disorders are described in whom asymmetric septal hypertrophy was revealed by echocardiography. In one of these patients coexisting hypertrophic cardiomyopathy was excluded histologically; thus asymmetrical septal hypertrophy is not confined to patients with hypertrophic cardiomyopathy.

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Selected References

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  1. Abbasi A. S., MacAlpin R. N., Eber L. M., Pearce M. L. Echocardiographic diagnosis of idiopathic hypertrophic cardiomyopathy without outflow obstruction. Circulation. 1972 Nov;46(5):897–904. doi: 10.1161/01.cir.46.5.897. [DOI] [PubMed] [Google Scholar]
  2. BENTALL H. H., CLELAND W. P., OAKLEY C. M., SHAH P. M., STEINER R. E., GOODWIN J. F. SURGICAL TREATMENT AND POST-OPERATIVE HAEMODYNAMIC STUDIES IN HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY. Br Heart J. 1965 Jul;27:585–594. doi: 10.1136/hrt.27.4.585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cardelia J. U., Befeler B., Hildner F. J., Samet P. Hypertrophic subaortic stenosis complicated by aortic insufficiency and subacute bacterial endocarditis. Am Heart J. 1971 Apr;81(4):543–547. doi: 10.1016/0002-8703(71)90371-1. [DOI] [PubMed] [Google Scholar]
  4. Chung K. J., Manning J. A., Gramiak R. Echocardiography in coexisting hypertrophic subaortic stenosis and fixed left ventricular outflow obstruction. Circulation. 1974 Apr;49(4):673–677. doi: 10.1161/01.cir.49.4.673. [DOI] [PubMed] [Google Scholar]
  5. Cooley D. A., Leachman R. D., Hallman G. L., Gerami S., Hall R. J. Idiopathic hypertrophic subaortic stenosis. Surgical treatment including mitral valve replacement. Arch Surg. 1971 Nov;103(5):606–609. doi: 10.1001/archsurg.1971.01350110108017. [DOI] [PubMed] [Google Scholar]
  6. Dinsmore R. E., Sanders C. A., Harthorne J. W. Mitral regurgitation in idiopathic hypertrophic subaortic stenosis. N Engl J Med. 1966 Dec 1;275(22):1225–1228. doi: 10.1056/NEJM196612012752204. [DOI] [PubMed] [Google Scholar]
  7. Duchak J. M., Jr, Chang S., Feigenbaum H. The posterior mitral valve echo and the echocardiographic diagnosis of mitral stenosis. Am J Cardiol. 1972 May;29(5):628–632. doi: 10.1016/0002-9149(72)90163-4. [DOI] [PubMed] [Google Scholar]
  8. Feigenbaum H. Clinical applications of echocardiography. Prog Cardiovasc Dis. 1972 May;14(6):531–558. doi: 10.1016/0033-0620(72)90007-2. [DOI] [PubMed] [Google Scholar]
  9. Feizi O., Symons C., Yacoub M. Echocardiography of the aortic valve. I. Studies of normal aortic valve, aortic stenosis, aortic regurgitation, and mixed aortic valve disease. Br Heart J. 1974 Apr;36(4):341–351. doi: 10.1136/hrt.36.4.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Frank S., Braunwald E. Idiopathic hypertrophic subaortic stenosis. Clinical analysis of 126 patients with emphasis on the natural history. Circulation. 1968 May;37(5):759–788. doi: 10.1161/01.cir.37.5.759. [DOI] [PubMed] [Google Scholar]
  11. GOODWIN J. F. CARDIAC FUNCTION IN PRIMARY MYOCARDIAL DISORDERS. I. Br Med J. 1964 Jun 13;1(5397):1527–1533. doi: 10.1136/bmj.1.5397.1527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Gramiak R., Shah P. M., Kramer D. H. Ultrasound cardiography: contrast studies in anatomy and function. Radiology. 1969 Apr;92(5):939–948. doi: 10.1148/92.5.939. [DOI] [PubMed] [Google Scholar]
  13. HANSEN P. F., DAVIDSEN H. G., FABRICIUS J. Subvalvular aortic stenosis of muscular type. Acta Med Scand. 1962 Jun;171:743–751. doi: 10.1111/j.0954-6820.1962.tb04240.x. [DOI] [PubMed] [Google Scholar]
  14. Henry W. L., Clark C. E., Epstein S. E. Asymmetric septal hypertrophy. Echocardiographic identification of the pathognomonic anatomic abnormality of IHSS. Circulation. 1973 Feb;47(2):225–233. doi: 10.1161/01.cir.47.2.225. [DOI] [PubMed] [Google Scholar]
  15. MENGES H., Jr, BRANDENBURG R. O., BROWN A. L., Jr The clinical, hemodynamic, and pathologic diagnosis of muscular subvalvular aortic stenosis. Circulation. 1961 Nov;24:1126–1136. doi: 10.1161/01.cir.24.5.1126. [DOI] [PubMed] [Google Scholar]
  16. Moreyra E., Elein J. J., Shimada H., Segal B. L. Idiopathic hypertrophic subaortic stenosis diagnosed by reflected ultrasound. Am J Cardiol. 1969 Jan;23(1):32–37. doi: 10.1016/0002-9149(69)90238-0. [DOI] [PubMed] [Google Scholar]
  17. Nagle J. P. Idiopathic hypertrophic subaortic stenosis and bacterial endocarditis. JAMA. 1967 May 15;200(7):643–645. [PubMed] [Google Scholar]
  18. Popp R. L., Harrison D. C. Ultrasound in the diagnosis and evaluation of therapy of idiopathic hypertrophic subaortic stenosis. Circulation. 1969 Dec;40(6):905–914. doi: 10.1161/01.cir.40.6.905. [DOI] [PubMed] [Google Scholar]
  19. Pridie R. B., Oakley C. M. Mechanism of mitral regurgitation in hypertrophic obstructive cardiomyopathy. Br Heart J. 1970 Mar;32(2):203–208. doi: 10.1136/hrt.32.2.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Shabetal R., Davidson S. Asymmetrical hypertrophic cardiomyopathy simulating mitral stenosis. Circulation. 1972 Jan;45(1):37–45. doi: 10.1161/01.cir.45.1.37. [DOI] [PubMed] [Google Scholar]
  21. Shah P. M., Gramiak R., Kramer D. H. Ultrasound localization of left ventricular outflow obstruction in hypertrophic obstructive cardiomyopathy. Circulation. 1969 Jul;40(1):3–11. doi: 10.1161/01.cir.40.1.3. [DOI] [PubMed] [Google Scholar]
  22. Shah P. M., Gramiak R., Kramer D. H., Yu P. N. Determinants of atrial (S4) and ventricular (S3) gallop sounds in primary myocardial disease. N Engl J Med. 1968 Apr 4;278(14):753–758. doi: 10.1056/NEJM196804042781402. [DOI] [PubMed] [Google Scholar]
  23. Simon A. L., Ross J., Jr, Gault J. H. Angiographic anatomy of the left ventricle and mitral valve in idiopathic hypertrophic subaortic stenosis. Circulation. 1967 Dec;36(6):852–867. doi: 10.1161/01.cir.36.6.852. [DOI] [PubMed] [Google Scholar]
  24. TEARE D. Asymmetrical hypertrophy of the heart in young adults. Br Heart J. 1958 Jan;20(1):1–8. doi: 10.1136/hrt.20.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Wigle E. D., Adelman A. G., Auger P., Marquis Y. Mitral regurgitation in muscular subaortic stenosis. Am J Cardiol. 1969 Nov;24(5):698–706. doi: 10.1016/0002-9149(69)90457-3. [DOI] [PubMed] [Google Scholar]

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