Document Detail


Increased intraventricular velocities: an unrecognized cause of systolic murmur in adults.
MedLine Citation:
PMID:  9822083     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to determine the frequency, clinical features and echocardiographic characteristics of increased intraventricular velocities (IIVs) in patients referred to the echocardiography laboratory for systolic murmur. BACKGROUND: A subset of patients referred to the echocardiography laboratory for evaluation of a systolic murmur have IIVs in the absence of other recognized causes of systolic murmur. METHODS: We prospectively studied echocardiograms from 108 consecutive patients referred for evaluation of a systolic murmur. Clinical data were obtained from patient examinations and medical records. RESULTS: The sole explanation for systolic murmur was IIVs in 16.7% of referred patients. Compared with those without IIVs, patients with IIVs had a higher ejection fraction (EF) (58.7+/-7.8% vs. 51.1+/-12.5%, p < 0.001), percent fractional shortening (42.3+/-9.7% vs. 31.0+/-11.4%, p < 0.0001), left ventricular (LV) mass index (181+/-70 vs. 152+/-48 g/m2, p=0.046) and prevalence of hypertension (73.3% vs. 51.7%, p=0.043) and a lower prevalence of segmental wall motion abnormalities (2.2% vs. 39.3%, p < 0.001). CONCLUSIONS: Increased intraventricular velocities are a common cause of systolic murmur in this group of patients and should be included in the differential diagnosis of systolic murmurs in adults. The association of IIVs with LV hypertrophy should be a clinical consideration when these murmurs are identified.
Authors:
P H Spooner; M P Perry; R O Brandenburg; G D Pennock
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  32     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-16     Completed Date:  1998-12-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1589-95     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Tucson Veterans Affairs Medical Center and University of Arizona 85723, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Auscultation
Blood Flow Velocity / physiology*
Coronary Circulation / physiology*
Echocardiography
Echocardiography, Doppler
Female
Heart Murmurs / diagnosis,  etiology*,  ultrasonography
Humans
Male
Prospective Studies
Systole
Ventricular Function / physiology*
Comments/Corrections
Comment In:
J Am Coll Cardiol. 1998 Nov 15;32(6):1596-602   [PMID:  9822084 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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