Mitral valve remodeling in the development of obstructive hypertrophic cardiomyopathy

Figures

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  Fig. 1. Mitral valve morphology and development of left ventricular outflow tract obstruction in non-obstructive hypertrophic cardiomyopathy, and characteristics of the patient population. Top panels display graphically mitral valve morphological changes in the setting of the development of obstruction. Panel A: Leaflet length was measured in apical 3 chamber view in mid-diastole. Protrusion length was measured as the distance between coaptation point and mitral annular plane. Residual length was measured as the length of the anterior mitral valve leaflet beyond the point of coaptation. Wall thickness and ventricular dimensions were measured in end-diastolic frames. Panel B and Panel C show residual length and peak left ventricular outflow tract gradient in a patient who developed significant obstruction at follow up. Note the increase in residual length from 1 mm to 7 mm and the significant increase in left ventricular outflow tract gradient between baseline and follow up echocardiogram approximately 4 years apart. Bottom panel show baseline and follow up echocardiographic variables. LAVi, left atrial volume index; LVEDD, left ventricular end-diastolic diameter; LVEF, left ventricular…