An unusual pattern of the mitral echocardiogram observed in cases of congestive cardiomyopathy and other myocardial diseases.
(1) Narrowness of the early-diastolic and presystolic peaks on the echo curve of the anterior mitral leaflet and an abnormal step formation at the middle or higher level on the descending limb of the presystolic peak were observed in 7 cases with congestive cardiomyopathy or myocardial fibrosis, 1 case with myocardial infarction, and 1 case with cardiomyopathy due to progressive muscular dystrophy. (2) This abnormal pattern is considered to be closely related to the myocardial condition in the above-mentioned diseases. (3) Probable mechanisms for this pattern formation are considered as follows: (i) a sudden reduction of distensibility of the left ventricle after filling of the ventricle over a certain limit near full-filling, and impaired ventricular contractility, (ii) restriction in the mobility of the mitral valve and its chardae due to thier inability to adapt themselves to a developed dilatation of the left ventricle. (4) A similar presystolic step formation on the echo curve of the anterior mitral leaflet was observed in 3 of 25 cases of hypertrophic cardiomyopathy of Goodwin's sense. Differences between the myocardial state in congestive cardiomyopathy or in similar myocardial diseases and that in hypertrophic cardiomyopathy were also discussed.
D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology; D009205:Myocarditis / Q000175:diagnosis / Q000503:physiopathology