Moro E, ten Cate F J, Leonard J J, Roelandt J
Thoraxcenter, Erasmus University and Academic Hospital Dijkzigt-Rotterdam, The Netherlands.
Int J Cardiol. 1987 Nov;17(2):197-205. doi: 10.1016/0167-5273(87)90131-8.
Cross-sectional echocardiography was used to identify systolic anterior motion of the mural (posterior) leaflet of the mitral valve from a group of 53 patients with hypertrophic cardiomyopathy. This type of systolic anterior motion was identified in parasternal long axis, apical four-chamber and/or long-axis cross-sections and was characterized by an elongation of the mural leaflet and an abnormal coaptation with the aortic (anterior) leaflet. At end-diastole, the aortic leaflet coapted at the basal or mid portion of the mural leaflet, leaving its distal "residual" segment in the left ventricle. Subsequently, during systole this "residual" segment approached or touched the ventricular septum. Systolic anterior motion of the mural leaflet was present in 6 (12%) of our patients with hypertrophic cardiomyopathy. Lengthening of the leaflet and an abnormal coaptation were associated with increased thickening of the posterior wall of the left ventricle and narrowing of the left ventricular outflow tract. All these elements contribute to the occurrence of systolic anterior motion and left ventricular tract obstruction.
采用横断面超声心动图对53例肥厚型心肌病患者二尖瓣壁（后）叶收缩期前向运动进行识别。这种类型的收缩期前向运动在胸骨旁长轴、心尖四腔心和/或长轴横切面中得以识别，其特征为壁叶延长并与主动脉（前）叶异常对合。在舒张末期，主动脉叶在壁叶的基部或中部对合，使其远端“残余”段留在左心室内。随后，在收缩期，这段“残余”段靠近或触及室间隔。我们的肥厚型心肌病患者中有6例（12%）出现二尖瓣壁叶收缩期前向运动。瓣叶延长及异常对合与左心室后壁增厚增加及左心室流出道狭窄有关。所有这些因素均促使收缩期前向运动及左心室流出道梗阻的发生。
