Terumi Hayashi

Aortic Valve Motion in Mitral Valve Prolapse Syndrome

Since the echocardiographic study of Shah and Gramiak in mitral valve prolapse (MVP) syndrome, there have been many reports concerning MV echo patterns of this syndrome. However, aortic valve (AV) echogram has not been described in detail. The purpose of the present study is to investigate AV motion of MVP syndrome.

Abnormal Motion of Interventricular Septum and Posterior Wall of Left Ventricle in Experimental “Wolff-Parkinson-White Syndrome” : Echocardiographic and Electrophysiologic Study

With the advent of echocardiography, the examination of motion of interventricular septum(IVS) and left ventricular posterior wall (LVPW) has become very important in the diagnosis of cardiac abnormalities. Some clinical reports on Wolff-Parkinson-White(WPW) syndrome, which is one of the conditions known to affect the motion of IVS and LVPW, demonstrate that, in Type A, LVPW shows early onset and peak formation of the anterior motion and that, in Type B, IVS shows early systolic posterior protrusion and subsequent paradoxical anterior motion, which are quite similar to those observed in left bundle branch block. Although some believe that unopposed systolic contraction of either right(RV) or left ventricle(LV) and/or reversed activation of IVS from right to left resulted in these abnormal motion, the exact mechanism still remain uncertain.

Echocardiogram in Pulsus Paradoxus: Respiration Dependent Cyclic Changes in Mitral and Aortic Valve Motion

The mechanism of production of pulsus paradoxus was echocardiographically studied in a 74-year-old male with subacute effusive-constrictive pericarditis which developed to constrictive pericarditis under the observation. Echocardiography disclosed the following phenomena during inspiration: 1) mitral valve did not open until the atrial systole, probably because of the lack of antegrade mitral flow during rapid filling phase (the E wave was not observed), 2) concomitantly, aortic valve opening decreased markedly in its grade, and 3) left ventricular ejection time (LVET) decreased and pre-ejection period (PEP) increased, resulting in a higher PEP/LVET ratio (up to 1.32). The opposite was true during expiration (PEP/LVET ratio was 0.40). This is probably the first case, in which the mechanism of pulsus paradoxus was investigated by aortic and mitral valve echograms.

Correlative Study of Pulmonary Valve Echogram and Indirect Pulmonary Artery Pulse

Recently, echocardiographic assessment of right ventricular (RV) performance by measurement of systolic time intervals (RSTIs) has been possible because of increased detectability of the sufficient pulmonary valve echo. In the previous study, we recorded indirect pulmonary artery pulse (PA pulse) tracing in patients with various conditions and preliminarily reported the method to measure RSTIs. Since these 2 techniques are the noninvasive method available at the present time for the assessment of RV performance, the purpose of this study is to obtain simultaneously these 2 records to evaluate the validity of each of them.