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Experimental study| Volume 34, ISSUE 1, P63-71, July 1974

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Simulated left atrial tumor

A hemodynamic, echocardiographic and cineangiographic study
  • Howard L. Moscovitz
    Correspondence
    Address for reprints: Howard L. Moscovitz, MD, the Mount Sinai School of Medicine of the City University of New York, Fifth Ave. and 100th St., New York, New York 10029.
    Affiliations
    From the Division of Cardiology, Department of Medicine, the Mount Sinai Hospital and Mount Sinai School of Medicine of the City University of New York, New York, N. Y., USA
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  • John Pantazopoulos
    Affiliations
    From the Division of Cardiology, Department of Medicine, the Mount Sinai Hospital and Mount Sinai School of Medicine of the City University of New York, New York, N. Y., USA
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  • Monty Bodenheimer
    Affiliations
    From the Division of Cardiology, Department of Medicine, the Mount Sinai Hospital and Mount Sinai School of Medicine of the City University of New York, New York, N. Y., USA
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  • Moshe Steier
    Affiliations
    From the Division of Cardiology, Department of Medicine, the Mount Sinai Hospital and Mount Sinai School of Medicine of the City University of New York, New York, N. Y., USA
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  • Ira J. Gelb
    Affiliations
    From the Division of Cardiology, Department of Medicine, the Mount Sinai Hospital and Mount Sinai School of Medicine of the City University of New York, New York, N. Y., USA
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      Abstract

      An experimental model of a prolapsing left atrial tumor mass has been utilized In dogs to study the hemodynamic events of the cardiac cycle and the cineangiographic and echocardiographic manifestations of this condition. The characteristic ventricular notch has been correlated with the timing of the expulsion of the simulated tumor mass from the left ventricle to the left atrium. The early notch seen with small simulated tumors delays aortic ejection by 0.02 to 0.03 second and results in abbreviated aortic ejection time and minimal distortion of the E-F slope of anterior mitral leaflet motion in the echocardiogram. Larger masses lead to late ventricular notching, transiently interrupt aortic flow and may displace the anterior mitral leaflet until It impinges on the interventricular septum in mid-diastole and at the onset of systole. A transient systolic Increment of coronary flow is observed after expulsion of the tumor from the left ventricle into the left atrium. There is an echo-free interval immediately after opening of the mitral valve, indicating that tumor motion lags perceptibly behind the initial blood flow through the mitral orifice. The sudden expulsion of the mass from the ventricle to the atrium early in systole represents an in vivo example of the quick release phenomenon.
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      References

        • Goodwin JF
        Diagnosis of left atrial myxoma.
        Lancet. 1963; 1: 464-468
        • Penny JL
        • Gregory JJ
        • Ayres SM
        • et al.
        Calcified left atrial myxoma simulating mitral insufficiency. Hemodynamic and phonocardiographic effects of tumor movement.
        Circulation. 1967; 36: 417-421
        • Pitt A
        • Pitt B
        • Schaefer J
        • et al.
        Myxoma of the left atrium. Hemodynamic and phonocardiographic consequences of sudden tumor movement.
        Circulation. 1967; 36: 408-416
        • Zitnik RS
        • Giuliani ER
        • Burchell HB
        Left atrial myxoma. Phonocardiographic clues to diagnosis.
        Am J Cardiol. 1969; 23: 588-591
        • Bower PJ
        • Ritter DG
        • Caliahan JA
        • et al.
        Unusual hemodynamic findings of diagnostic value in a case of left atrial myxoma.
        Am J Cardiol. 1969; 23: 592-596
        • Nasser WK
        • Davis RH
        • Dillon JC
        • et al.
        Atrial myxoma. II. Phonocardiographic, echocardiographic, hemodynamic, and angiographic features in nine cases.
        Am Heart J. 1972; 83: 810-824
        • Selzer A
        • Sakai FJ
        • Popper RW
        Protean clinical manifestations of primary tumors of the heart.
        Am J Med. 1972; 52: 9-18
        • Ghahramani AR
        • Arnold JR
        • Hildner FJ
        • et al.
        Left atrial myxoma. Hemodynamic and phonocardiographic features.
        Am J Med. 1972; 52: 525-532
        • Malloch CI
        • Abbott JA
        • Rapaport E
        Left atrial myxoma with bacteremia. Report of a case with a bifid systolic apical impulse.
        Am J Cardiol. 1970; 25: 353-358
        • Becker LC
        • Contl CR
        Left atrial myxoma: evidence of tumor movement by apexcardiogram.
        Chest. 1971; 60: 280-282
        • Craige E
        • Algary WP
        Left atrial myxoma. Diagnosis with the help of the phonocardiogram and apexcardiogram.
        Arch Intern Med. 1972; 129: 470-474
        • Lefcoe NM
        • Brien FS
        • Manning GW
        An opening snap recorded in a case of tumor of the left atrium.
        N Engl J Med. 1957; 257: 178-180
      1. Clinicopathologic conference. second ed. N Engl J Med. 287. 1972: 555-561
        • Schattenberg TT
        Echocardiographic diagnosis of left atrial myxoma.
        in: second ed. Mayo Clin Proc. 61. 1968: 620-627
        • Wolfe SB
        • Popp RL
        • Feigenbaum H
        Diagnosis of atrial tumors by ultrasound.
        Circulation. 1969; 39: 615-622
        • Kostis JB
        • Moghadonn AN
        Echocardiographic diagnosis of left atrial myxoma.
        Chest. 1970; 58: 550-552
        • Piemme TE
        • Dexter L
        Pressure transients occurring in diastole in the central aorta.
        Circ Res. 1963; 13: 585-594
        • Greenwood WF
        Profile of atrial myxoma.
        Am J Cardiol. 1968; 21: 367-375
        • Braunwald E
        Seminars in medicine of the Beth Israel Hospital, Boston: mitral regurgitation. second ed. N Engl J Med. 281. 1969: 425-433
        • Harbold NB
        • Gan GT
        Echocardiographic diagnosis of right atrial myxoma.
        in: second ed. Mayo Clin Proc. 48. 1973: 284-286
        • Bellhouse BJ
        Fluid mechanics of a model mitral valve.
        J Physiol. 1970; 207: 72-73
        • Feigenbaum H
        Newer aspects of echocardiography.
        Circulation. 1973; 37: 833-842
        • Duchak Jr, JM
        • Chang S
        • Felgenbaum H
        The posterior mitral valve echo and the electrocardiographic diagnosis of mitral stenosis.
        Am J Cardiol. 1972; 29: 628-632
        • Edman KAP
        • Nilsson E
        Time course of the active state in relation to muscle length and movement: a comparative study on skeletal muscle and myocardium.
        Cardiovasc Res. 1971; 1: 3-10