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Diversity of structural mitral valve alterations in hypertrophic cardiomyopathy

H G Klues1, B J Maron, A L Dollar

  • 1Pathology Branches, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md 20892.

Circulation
|May 1, 1992
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) involves more than just heart muscle; many patients also exhibit structural mitral valve abnormalities. These include enlarged leaflets and unusual papillary muscle connections, suggesting a broader disease process.

Area of Science:

  • Cardiology
  • Cardiac Morphology
  • Valvular Heart Disease

Background:

  • Hypertrophic cardiomyopathy (HCM) is defined by left ventricular hypertrophy.
  • HCM is traditionally considered a disease of cardiac muscle.

Purpose of the Study:

  • To investigate potential mitral valve involvement in hypertrophic cardiomyopathy.
  • To determine if structural abnormalities of the mitral valve are present in HCM patients.

Main Methods:

  • Studied mitral valves from 94 patients with HCM and 45 controls.
  • Measured mitral leaflet area, length, and circumference.
  • Assessed for anomalous papillary muscle insertions.

Main Results:

  • Mitral leaflet area was significantly increased in HCM patients (12.9 cm² vs. 8.7 cm²).
  • Increased area was due to leaflet elongation, particularly the anterior leaflet.
  • 58% of HCM valves showed increased leaflet area; 66% had malformations including anomalous papillary muscle insertion.

Conclusions:

  • HCM involves structural mitral valve abnormalities in a majority of patients.
  • These include increased leaflet size, elongation, and anomalous papillary muscle insertions.
  • The disease process extends beyond cardiac muscle to affect mitral valve structure.
Abstract

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