What is the clinical evidence from this study?

Study design: Observational. Population: Idiopathic hypertrophic subaortic stenosis (n=36). Intervention: Angiography. Primary outcome: Characteristic combination of angiographic abnormalities.

What question did this study set out to answer?

To characterize the angiographic and anatomic abnormalities of the left ventricle and mitral valve responsible for outflow tract obstruction in idiopathic hypertrophic subaortic stenosis.

December 1, 1967Circulation

Angiographic Anatomy of the Left Ventricle and Mitral Valve in Idiopathic Hypertrophic Subaortic Stenosis

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Key result

Angiographic evaluation of the left ventricle in idiopathic hypertrophic subaortic stenosis revealed characteristic anatomical abnormalities causing obstruction in 91.7% (33 of 36) of studies.

Population

36 patients/studies with idiopathic hypertrophic subaortic stenosis and clinical/hemodynamic evidence of…

Design

Case_series

Authors

ASAllan L. SimonNational Institutes of Health JRJohn RossUniversité de Technologie de Compiègne JGJames H. GaultNational Institutes of Health

Discussion

Member takes

Implication

Highlights angiographic SAM in HCM obstruction; leaves open validation with modern imaging before clinical adoption.

Key Points

To characterize the angiographic and anatomic abnormalities of the left ventricle and mitral valve responsible for outflow tract obstruction in idiopathic hypertrophic subaortic stenosis.
Evaluated 36 technically satisfactory combined hemodynamic and angiographic studies in patients with obstructive idiopathic hypertrophic subaortic stenosis.
Analyzed left ventricular outflow tract morphology, mitral valve leaflet dynamics, and papillary muscle position across frontal, left oblique, and lateral projections during systole.
Characteristic structural abnormalities occurred in 33 of 36 studies (91.7%), including a linear radiolucent area in the outflow tract 2 to 2.5 cm below the aortic annulus corresponding to the site of pressure gradient change.
Severe septal hypertrophy displaced papillary muscles superiorly and leftward, exerting abnormal traction on chordae tendineae and projecting mitral leaflets into the outflow tract against the septum during mid-to-late systole.

Study Design

Type

Observational (n=36)

Structured PICO

Population

36 patients/studies with idiopathic hypertrophic subaortic stenosis and clinical/hemodynamic evidence of obstruction

Intervention

Angiographic and hemodynamic evaluation

Outcome

Angiographic features of the left ventricle and mitral valvesurrogate

This early study describes the angiographic mechanism of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, highlighting the role of systolic anterior motion of the mitral valve.

Cite This Study

Simon et al. (1967) conducted an observational in Idiopathic hypertrophic subaortic stenosis (n=36). Angiography was evaluated on Characteristic combination of angiographic abnormalities. Angiographic evaluation of the left ventricle in idiopathic hypertrophic subaortic stenosis revealed characteristic anatomical abnormalities causing obstruction in 91.7% (33 of 36) of studies.

synapsesocial.com/papers/6a08de2f73760a4edcd60625 https://doi.org/10.1161/01.cir.36.6.852

Topics

Hypertrophic cardiomyopathy

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Angiographic Anatomy of the Left Ventricle and Mitral Valve in Idiopathic Hypertrophic Subaortic Stenosis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Angiographic Anatomy of the Left Ventricle and Mitral Valve in Idiopathic Hypertrophic Subaortic Stenosis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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