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European Heart Journal 1983 4(12):838-845;
Copyright © 1983 by the European Society of Cardiology.
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© 1983, by the European Society of Cardiology

‘Pseudo’ systolic anterior motion in patients with hypertensive heart disease

YOSHINORI L. DOI*,, WILLIAM J. MCKENNA, CELIA M. OAKLEY and JOHN F. GOODWIN

The Division of Cardiovascular Disease (Clinical Cardiology), Royal Postgraduate Medical School, Hammersmith Hospital London, U.K.

Received 10 November 1982; .

Requests for reprints to: Yoshinori L. Doi, M.D., The Section of Cardiology, Department of Medicine & Geriatrics, University of Kochi Medical School, Oko-cho, Nankoku-shi, Kochi, Japan 781–51.

Abstract

The systolic motion of the mitral apparatus in patients with hypertensive heart disease and hypertrophic cardiomyopathy was studied in order to quantify the difference. Twelve out of 37 patients with severe systemic hypertension were found to have abnormal systolic anterior motion and had significantly smaller left ventricular end-systolic dimension (P <0.05) and greater ejection fraction and mean velocity of circumferential fibre shortening (P <0.01 for each) than the other hypertensive patients without abnormal systolic anterior motion. A comparison between systolic anterior motion in 12 hypertensive patients and mild or moderate systolic anterior motion in 28 patients with hypertrophic cardiomyopathy showed a clear cut difference. ‘Pseudo’ systolic anterior motion reached its peak at end-systole when the posterior wall had contracted fully. ‘True’ systolic anterior motion, however, reached its peak much earlier than maximum movement of the posterior wall—approximately after two-thirds of systole had been completed. At the time of mitral valve opening, ‘pseudo’ systolic anterior motion had not yet returned to this initial level, whereas ‘true’ systolic anterior motion returned prior to the opening of the mitral valve. Anterior chordal motion in hyperdynamic ventricle appears to play a role in the production of ‘pseudo’ systolic anterior motion.

Key Words: Echocardiogram • ‘pseudo’ systolic anterior motion • hypertensive heart disease • hypertro-phic cardiomyopathy


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