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Two cases showing alterations of the order of tricuspid and mitral valve opening during loading manipulations: a new approach for quick assessment of stress-induced left ventricular filling pressure elevation

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Authors and Affiliations

  1. Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan

    Michito Murayama

  2. Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan

    Hiroyuki Iwano, Ko Motoi, Suguru Ishizaka, Shingo Tsujinaga, Toshiyuki Nagai & Toshihisa Anzai

  3. Division of Cardiology, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, 041-8680, Japan

    Hiroyuki Iwano

Authors
  1. Michito Murayama
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  2. Hiroyuki Iwano
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  3. Ko Motoi
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  4. Suguru Ishizaka
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  5. Shingo Tsujinaga
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  6. Toshiyuki Nagai
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  7. Toshihisa Anzai
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Corresponding author

Correspondence to Hiroyuki Iwano.

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Conflict of interest

Michito Murayama, Hiroyuki Iwano, Ko Motoi, Suguru Ishizaka, Shingo Tsujinaga, Toshiyuki Nagai, and Toshihisa Anzai declare that they have no conflicts of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

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Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 Supplemental Video 1. Order of tricuspid and mitral valve opening at rest in case 1. During slow playback, we can appreciate the earlier opening of the tricuspid valve. (MPG 4796 KB)

Supplementary file2 Supplemental Video 2. Order of tricuspid and mitral valve opening during exercise in case 1. During slow playback, we can appreciate the earlier opening of the mitral valve. (MPG 4268 KB)

Supplementary file3 Supplemental Video 3. Order of tricuspid and mitral valve opening at rest in case 2. During slow playback, we can notice that both atrioventricular valves open almost simultaneously. (MPG 2602 KB)

Supplementary file4 Supplemental Video 4. Order of tricuspid and mitral valve opening during passive leg lifts in case 2. During slow playback, we can appreciate the earlier opening of the mitral valve on the first and third beat, whereas both valves open almost simultaneously in the second beat. This image was judged as the mitral valve opening first. When beat-to-beat variability was observed, six to nine beats were used, and the majority result was used for the final judgment. (MPG 7398 KB)

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Murayama, M., Iwano, H., Motoi, K. et al. Two cases showing alterations of the order of tricuspid and mitral valve opening during loading manipulations: a new approach for quick assessment of stress-induced left ventricular filling pressure elevation. J Med Ultrasonics 49, 489–491 (2022). https://doi.org/10.1007/s10396-022-01224-4

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  • DOI: https://doi.org/10.1007/s10396-022-01224-4

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