Angiocardiographic study of obstructive cardiomyopathies. Attempt to evaluate the role of the interventricular septum and the great mitral valve in the obstructive phenomenon
Calazel, P.; Tricoire, J.; Donzeau, J.P.; Bernadet, P.
Archives des Maladies du Coeur et des Vaisseaux 69(8): 765-776
1976
ISSN/ISBN: 0003-9683 PMID: 823915 Document Number: 105697
Images of the left ventricles, taken in two planes at ventriculography in 45 established cases of obstructive cardiomyopathy, were subjected to a special type of analysis which allowed certain sectional and angular measurements to be made. In particular we calculated and end-systolic index of obstruction, and two measures of the contribution of the septum and the mitral valve to the subaortic obstruction. It then proved possible to study the part played in the stenosis by the interventricular septum and the mitral valve respectively, and to classify the obstructive cardiomyopathies by these criteria. The orientation of the sigmoid floor also seems to play a vital role in determining the dominance of the septum or the mitral valve. These three factors, when examined together, allow us to conclude that there are fixed factors which determine the existance of obstructive cardiomyopathy, to calculate the degree of mitral contribution to the obstruction, and to realise that the orientation of the sigmoid floor helps us to distinguish the type of obstruction. The combination leads to an angiocardiographic classification of the obstructive cardiomyopathies, and the prognostic and surgical significance of this classification are discussed.