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Mitral stenosis: mitral dome excursion at M1 and the mitral opening snap--the concept of reciprocal heart sounds.

Publication ,  Journal Article
Barrington, WW; Boudoulas, H; Bashore, T; Olson, S; Wooley, CF
Published in: Am Heart J
June 1988

The dynamics of the delayed accentuated mitral component (M1) of the first heart sound and the MOS were studied in 11 patients with mitral stenosis of varying severity. Echophonocardiographic (M-mode and 2D) studies were performed with analysis of LA dimensions, dynamics, and mitral valve excursion at the time of M1 and MOS. LA area and length, mitral annular diameter, and mitral dome area (from anulus plane to fused valve tip) and length were measured at M1 and MOS. Significant dynamic increases in mitral dome area and length occurred from M1 to MOS, with less striking but consistent increases in LA area, LA length, and mitral annular diameter. Conversely, mitral dome area and length decreased significantly from MOS to M1, with less striking but consistent decreases in LA area, LA length, and mitral annular diameter. Frame-by-frame video tape analysis showed that dome movement was separate from anulus motion. Mitral dome descent into the left ventricle terminated at MOS and reversal of dome motion terminated at M1. The conformational and dimensional changes that terminated abruptly at MOS reversed and terminated abruptly in a reciprocal manner at the time of the delayed, accentuated M1. When considered in light of known hemodynamic, pressure pulse, and imaging correlates in mitral stenosis, these observations strengthen the hypothesis that the mechanisms involved in the production of M1 and MOS in mitral stenosis are paired or reciprocal in nature, and the delayed, accentuated M1 and the MOS of mitral stenosis are reciprocal cardiovascular sounds.

Duke Scholars

Published In

Am Heart J

DOI

ISSN

0002-8703

Publication Date

June 1988

Volume

115

Issue

6

Start / End Page

1280 / 1290

Location

United States

Related Subject Headings

  • Phonocardiography
  • Mitral Valve Stenosis
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Heart Sounds
  • Heart Auscultation
  • Heart Atria
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Barrington, W. W., Boudoulas, H., Bashore, T., Olson, S., & Wooley, C. F. (1988). Mitral stenosis: mitral dome excursion at M1 and the mitral opening snap--the concept of reciprocal heart sounds. Am Heart J, 115(6), 1280–1290. https://doi.org/10.1016/0002-8703(88)90022-1
Barrington, W. W., H. Boudoulas, T. Bashore, S. Olson, and C. F. Wooley. “Mitral stenosis: mitral dome excursion at M1 and the mitral opening snap--the concept of reciprocal heart sounds.Am Heart J 115, no. 6 (June 1988): 1280–90. https://doi.org/10.1016/0002-8703(88)90022-1.
Barrington WW, Boudoulas H, Bashore T, Olson S, Wooley CF. Mitral stenosis: mitral dome excursion at M1 and the mitral opening snap--the concept of reciprocal heart sounds. Am Heart J. 1988 Jun;115(6):1280–90.
Barrington, W. W., et al. “Mitral stenosis: mitral dome excursion at M1 and the mitral opening snap--the concept of reciprocal heart sounds.Am Heart J, vol. 115, no. 6, June 1988, pp. 1280–90. Pubmed, doi:10.1016/0002-8703(88)90022-1.
Barrington WW, Boudoulas H, Bashore T, Olson S, Wooley CF. Mitral stenosis: mitral dome excursion at M1 and the mitral opening snap--the concept of reciprocal heart sounds. Am Heart J. 1988 Jun;115(6):1280–1290.
Journal cover image

Published In

Am Heart J

DOI

ISSN

0002-8703

Publication Date

June 1988

Volume

115

Issue

6

Start / End Page

1280 / 1290

Location

United States

Related Subject Headings

  • Phonocardiography
  • Mitral Valve Stenosis
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Heart Sounds
  • Heart Auscultation
  • Heart Atria
  • Female