Clinical features of the systolic anterior motion of the mitral valve among patients without hypertrophic cardiomyopathy

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• 作者：Shoko Uematsu ; MD^a ; ^b ; ^{s51030600@yahoo.co.jp} ; Atsushi Takaghi ; MD ; PhD ; FJCC^c ; Yasutaka Imamura ; MD^a ; Kyomi Ashihara ; MD ; PhD^a ; Nobuhisa Hagiwara ; MD ; PhD ; FJCC^a
• 关键词：Systolic anterior motion of the mitral valve ; Prevalence ; Chordal tendineae ; Left ventricular outflow tract obstruction ; Mitral regurgitation
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：69
• 期：2
• 页码：495-500
• 全文大小：778 K
• 卷排序：69

文摘

The prevalence and clinical features of the systolic anterior motion of the mitral valve (SAM) without hypertrophic cardiomyopathy (HCM) have not been studied well.MethodsRecords of 9180 sequential patients who underwent echocardiography at Tokyo Women's Medical University Hospital were reviewed. SAM patients were divided into those with HCM (HCM; n = 60, 68%) and those without HCM (non-HCM; n = 28, 32%). To assess SAM morphology, non-HCM patients were divided into the valvular and chordal groups.ResultsThe prevalence of non-HCM SAM was 0.3%. Non-HCM patients showed older age (65.7 ± 15.0 years vs. 56.9 ± 16.8 years, p = 0.02), higher prevalence of sigmoid septum (75% vs. 50%, p = 0.03), and lower left ventricular outflow tract pressure gradient (LVOT-PG) (27 ± 31 mmHg vs. 43 ± 41 mmHg, p = 0.03) than HCM patients. However, 8 of 28 non-HCM patients showed a LVOT-PG >30 mmHg. Valvular SAM showed higher dyspnea prevalence (29% vs. 0%, p = 0.04), higher LVOT-PG (39 ± 36 mmHg vs. 6 ± 2 mmHg, p < 0.001), longer anterior mitral leaflet (28 ± 2 mm vs. 26 ± 3 mm, p = 0.04) and more pronounced mitral regurgitation than chordal SAM.ConclusionNon-HCM SAM prevalence was 0.3% in the Japanese population. Non-HCM SAM correlated with older age, sigmoid septum, and a lower LVOT-PG compared with HCM SAM. Among non-HCM SAM, valvular SAM showed a significant symptom, higher LVOT-PG, and more pronounced mitral regurgitation than chordal SAM.