HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Spooner, P. H. Articles by Pennock, G. D. Search for Related Content PubMed PubMed Citation Articles by Spooner, P. H. Articles by Pennock, G. D.

CLINICAL STUDIES

Increased intraventricular velocities

An unrecognized cause of systolic murmur in adults

^a Department of Medicine, Tucson Veterans Affairs Medical Center and University of Arizona, Sarver Heart Center, Tucson, Arizona, USA

Manuscript received October 16, 1997; revised manuscript received May 27, 1998, accepted July 22, 1998.

Address for correspondence: Dr. Gregory D. Pennock, Cardiology, Room 111C, Tucson Veterans Affairs Medical Center, 3601 S. 6th Avenue, Tucson, Arizona 85723
pennock{at}flash.net

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.

Abbreviations and Acronyms   EF = ejection fraction   IIV = increased intraventricular velocity   LV = left ventricular   RWT = relative wall thickness