Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Jan 1989
Transesophageal Doppler color flow imaging in the detection of native and Björk-Shiley mitral valve regurgitation.
Regurgitant blood flow of mitral valves was studied by transesophageal Doppler color flow echocardiographic imaging in 11 healthy volunteers (Group 1), 25 cardiac patients with a native mitral valve (Group 2), 10 patients with a normally functioning Björk-Shiley mitral prosthesis without clinical evidence of mitral regurgitation (Group 3) and 10 patients with angiographic or surgical evidence of Björk-Shiley mitral valve regurgitation (Group 4). Holosystolic regurgitant color jets were classified as type I or type II. The data were compared with results obtained with precordial techniques, i.e., continuous wave and Doppler color flow echocardiographic imaging (Groups 1 to 4) and left ventricular angiography or surgery (Groups 2 and 4). ⋯ Transesophageal Doppler color flow imaging detected in 4 of the 20 patients a type I jet that was not visualized with precordial techniques in 2 patients. Type II jets were detected by the transesophageal technique in all five patients with proven mitral regurgitation and were also visualized with precordial echocardiography. All patients in Group 3 showed two identical type I jets that were not detected with precordial echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)
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J. Am. Coll. Cardiol. · Jan 1989
Elderly patients with hypertrophic cardiomyopathy: a subset with distinctive left ventricular morphology and progressive clinical course late in life.
This report describes a subgroup of 52 elderly patients with obstructive hypertrophic cardiomyopathy in whom certain clinical and morphologic features differed importantly from those of many other patients with this disease. Ages ranged from 60 to 84 years (mean 69) and 45 [87%] were women. Echocardiographic examination showed a relatively small heart, having only modest ventricular septal hypertrophy associated with marked distortion of left ventricular outflow tract morphology. ⋯ Of the 49 patients with at least 1 year follow-up study, only 12 had improvement with pharmacologic therapy; however, 14 of the 18 patients who underwent ventricular septal myotomy-myectomy or mitral valve replacement obtained symptomatic benefit from operation. In conclusion, obstructive hypertrophic cardiomyopathy in many elderly (and predominantly female) patients may assume a distinctive morphologic appearance and a progressive clinical course. This subgroup of patients appears to constitute an important segment of the disease spectrum of hypertrophic cardiomyopathy of cardiac disease in the elderly that previously has not been precisely defined nor fully appreciated.