title: Clinical features of the systolic anterior motion of the mitral valve among patients without hypertrophic cardiomyopathy.
abstract: The prevalence and clinical features of the systolic anterior motion of the mitral valve (SAM) without hypertrophic cardiomyopathy (HCM) have not been studied well.
  
  
  
  Records 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.
  
  
  
  The 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±31mmHg vs. 43±41mmHg, p=0.03) than HCM patients. However, 8 of 28 non-HCM patients showed a LVOT-PG >30mmHg. Valvular SAM showed higher dyspnea prevalence (29% vs. 0%, p=0.04), higher LVOT-PG (39±36mmHg vs. 6±2mmHg, p<0.001), longer anterior mitral leaflet (28±2mm vs. 26±3mm, p=0.04) and more pronounced mitral regurgitation than chordal SAM.
  
  
  
  Non-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.
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan; Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan. Electronic address: s51030600@yahoo.co.jp.
authors.forename: Shoko
authors.initials: S
authors.lastname: Uematsu
authors.affiliation: Department of Cardiology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takaghi
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Imamura
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kyomi
authors.initials: K
authors.lastname: Ashihara
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D000367:Age Factors; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology; D004417:Dyspnea / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D013599:Systole / Q000502:physiology*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Chordal tendineae; Left ventricular outflow tract obstruction; Mitral regurgitation; Prevalence; Systolic anterior motion of the mitral valve