ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2019
Accuracy of Jet Direction on Doppler Echocardiography in Identifying the Etiology of Mitral Regurgitation in Obstructive Hypertrophic Cardiomyopathy.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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23 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- A systematic review of present and future pharmaco-structural therapies for hypertrophic cardiomyopathy.Clinical cardiology · 2024Pooled it
- Pathogenesis, screening, and diagnosis of hypertrophic cardiomyopathy.BMJ medicine · 2026Review
- Mitral Transcatheter Edge-to-Edge Repair in Non-Surgical Candidates with Hypertrophic Obstructive Cardiomyopathy: Clip It, or Ablate It?Journal of cardiovascular development and disease · 2026Review
- Hypertrophic Cardiomyopathy: Current Perspectives.Reviews in cardiovascular medicine · 2025Review
- Echocardiography and Heart Failure: An Echocardiographic Decision Aid for the Diagnosis and Management of Cardiomyopathies.Current cardiology reports · 2025Review
- Hypertrophic Cardiomyopathy with Special Focus on Mavacamten and Its Future in Cardiology.Biomedicines · 2024Review
- Evolving Strategies for the Management of Obstructive Hypertrophic Cardiomyopathy.Journal of cardiac failure · 2024Review
- Hypertrophic cardiomyopathy with anteriorly directed mitral regurgitation is a red flag for concomitant pathology: a case report.European heart journal. Case reports · 2024Article
- Mitral regurgitation mechanisms related to systolic anterior motion in hypertrophic cardiomyopathy.Journal of thoracic disease · 2024Article
- Mexican guidelines 2024 for the diagnosis and treatment of hypertrophic cardiomyopathy.Archivos de cardiologia de Mexico · 2024Article
- Septal Myectomy Outcomes in Children and Adolescents With Obstructive Hypertrophic Cardiomyopathy.The Annals of thoracic surgery · 2023Article
- The use of MitraClip for nonobstructive hypertrophic cardiomyopathy with mixed severe mitral valve regurgitation.ESC heart failure · 2023Article
- Systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy: a narrative review.Journal of thoracic disease · 2022Review
- Different mechanisms of mitral regurgitation in hypertrophic cardiomyopathy: A clinical case and literature review.Frontiers in cardiovascular medicine · 2022Review
- Direct mitral regurgitation quantification in hypertrophic cardiomyopathy using 4D flow CMR jet tracking: evaluation in comparison to conventional CMR.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Article
- Surgery for Hypertrophic Obstructive Cardiomyopathy: Comprehensive LVOT Management beyond Septal Myectomy.Journal of clinical medicine · 2021Review
- 4D flow MRI left atrial kinetic energy in hypertrophic cardiomyopathy is associated with mitral regurgitation and left ventricular outflow tract obstruction.The international journal of cardiovascular imaging · 2021Article
- Transthoracic echocardiography of hypertrophic cardiomyopathy in adults: a practical guideline from the British Society of Echocardiography.Echo research and practice · 2021Article
- SAM and Severe Mitral Regurgitation Post-Acute Type A Aortic Dissection Surgery Treated With MitraClip.JACC. Case reports · 2020Article
- Management of the mitral valve in patients with obstructive hypertrophic cardiomyopathy.Indian journal of thoracic and cardiovascular surgery · 2020Review
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Abstract
backgroundMitral valve regurgitation (MR) mediated by systolic anterior motion (SAM) in obstructive hypertrophic cardiomyopathy (HCM) is traditionally characterized by a posteriorly directed jet on Doppler echocardiography. Many believe that MR in the absence of a posteriorly directed jet signals the presence of intrinsic mitral valve (MV) disease.
methodsA total of 709 adult patients with obstructive HCM who underwent septal myectomy were evaluated; 330 of these patients had >2 + MR preoperatively and constituted the study group. SAM-mediated MR was defined as MR that was eliminated or substantially reduced by myectomy for relief of left ventricular outflow tract obstruction with no need for MV intervention.
resultsOn preoperative transthoracic echocardiography, 168 of 258 patients with SAM-mediated MR and nine of 28 patients with intrinsic MV disease had isolated posterior jets, corresponding to sensitivity and specificity of 65.1% and 67.9% for identifying SAM-mediated MR; the positive predictive value was 94.9% and the negative predictive value was 17.4%. On prebypass transesophageal echocardiography, 169 of 284 patients with SAM-mediated MR and five of 28 patients with intrinsic MV disease had isolated posterior jets, corresponding to sensitivity and specificity of 59.5% and 82.1%; the positive predictive value and negative predictive value were 97.1% and 16.7%.
conclusionA posteriorly directed jet of MR in obstructive HCM correlates highly with SAM as the underlying pathophysiologic mechanism, but because of the low negative predictive value, clinicians should be cautious in using the jet direction of MR on preoperative transthoracic echocardiography to guide the decision for concomitant MV surgery during septal myectomy for HCM.
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