• Journal of Chest Surgery
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• 제25권9호
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• pp.936-942
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• 1992

There are three types of papillary muscle of the left ventricle[finger, tethered and mixed type] according to the morphology of the attachment to the ventricular wall. Especially finger type of the papillary muscle is more vulnerable to the injury than tethered or mixed type, because their blood supply is dependent upon the central artery whose diameter is less than 1mm and the papillary muscle itself is the end organ of the heart anatomically. There are several causes of papillary muscle rupture but few cases have been reported. Recently we have experienced 3 cases of papillary muscle rupture of the left ventricle with successful mitral valve replacement and the causes are postmyocardial infarction, percutaneous mitral valvulotomy and non-penetrating chest trauma. The common finding is the morphology of papillary muscle, that is the finger type and their rupture type is the complete type.

• 약학회지
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• 제29권4호
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• pp.199-205
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• 1985

It was previously reported that the deterioration rate of contractile force of the isolated heart from ginseng extract treated rat was slower than that from control. Present study was carried out to investigate the mechanism of the action of ginseng on the contractile force of the papillary muscle in terms of calcium metabolism. Rats weighing 200-300g were administered orally with ginseng ethanol extract (100mg/kg/day) for more than 10 days. The isolated papillary muscles from rat hearts were suspended in bath containing Krebs-Henseleit solution. When equilibration of contractile force of papillary muscle was reached, the rates of deterioration of contractile forces of papillary muscle from ginseng component treated rats were determined by washing with Ca-free Krebs-Henseleit solution and compared with that of normal hearts. At the beginning of washing, the rate of deterioration of contractile force of the papillary muscle was slower significantly in ginseng treated rats than in control rats, suggesting that calcium may be somehow involved in sustaining the contractility in ginseng treated hearts. Anoxia of papillary muscle with nitrogen gas to muscles inhibited the contractility, but differences between control and ginseng treated groups in the rate of deterioration were not observed. Influence of diltiazem, calcium blocker, on the contractility of papillary muscle from ginseng treated and control hearts was studied. Contractility of papillary muscle from control and ginseng treated hearts was inhibited by diltiazem in dose dependent manner but the inhibition of the ginseng treated muscles was much weak. The effect was significantly different. From the results, it seemed that slowing in deterioration rate of papillary muscle from ginseng treated hearts might be related to calcium which was mobilized from plasma membrane of internal organelle by ginseng.

• Journal of Chest Surgery
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• 제28권1호
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• pp.69-72
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• 1995

A 69-year-old patient with rupture of anterolateral papillary muscle following non-Q-wave myocardial infarction is described. Transesophageal echocardiography was useful in making the diagnosis. Mitral valve replacement was performed 22 days after the onset of acute myocardial infarction. The patient was discharged in his good condition and coronary angiography is scheduled.

• 대한치과의사협회지
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• 제16권7호통권110호
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• pp.531-536
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• 1978

Adult cats were light anesthetized with ethyl ether and heart was removed fastly. cardiac papillary muscle was dissected from heart in organ bath con taining Tyrode solution saturated with 95% O₂+5% CO₂, and prepared papillary muscles were placed in Tyrode solution that was continuously circulated and gassed with 95% O₂+5% CO₂at 32℃. The isolated papillary muscle was stimulated continuously with platinum pin electrode at frequency of 15/min and 90/min by means of electric stimulator and transmembrane action potentials were recorded with microelectrdes on the oscilloscope. The drug used was d-propranolol and its concentration was 0.5, 1.5 and 5.0 mg/L. The results obtained were as follows: 1. D-propranolol increased the threshold voltage of papillary muscle and raised by average of 213.6% of control. 2. D-propranolol had no effect on duration of action potential. 3. Conduction time of isolated papillary muscle was increased by d-propranolol and its effect was prominent at frequency of 90/min. 4. the maximum upstroke velocity was decreased by d-propranolol and its effect was dose-depndent decrease.

• Journal of Chest Surgery
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• 제44권4호
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• pp.285-287
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• 2011

A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.

• Journal of Chest Surgery
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• 제55권3호
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• pp.239-242
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• 2022

Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

• 한국임상수의학회지
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• 제34권4호
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• pp.279-282
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• 2017

A 9-month-old, female, mixed-breed dog was presented with dyspnea, exercise intolerance and a left apical heart murmur. Echocardiography revealed mitral systolic regurgitant flow by morphological abnormalities of the mitral apparatus including dilated annulus, excessively asymmetric mitral leaflets, short and stout chordae tendinae, and atrophic papillary muscles. The dog was diagnosed with congenital mitral dysplasia based on the echocardiographic features. Two months later, the dog died and the echocardiographic findings were confirmed by necropsy. This case report describes the echocardiographic features of mitral dysplasia with papillary muscle atrophy, and compares the gross necropsy findings in a dog.

• Korean Journal of Radiology
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• 제22권10호
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• pp.1609-1618
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• 2021

Objective: Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. Materials and Methods: This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. Results: LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29-36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. Conclusion: LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

• Journal of Chest Surgery
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• 제39권1호
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• pp.64-67
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• 2006

제1 대각지 단독 폐쇄에 의한 승모판막 전방 유두근의 파열은 매우 드물다. 66세 여자환자가 심근경색에 이은 심인성쇼크로 전원되었는데, 심초음파 및 관상동맥 조영술 결과 제1 대각지의 완전폐쇄와 승모판막 전방 유두근 파열 및 심한 승모판막 폐쇄부전증이 발견되어 응급 승모판막치환술 및 관상동맥 우회술 후 특별한 문제없이 회복하였다.

• The Korean Journal of Physiology
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• 제19권2호
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• pp.127-137
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• 1985

The present study was undertaken in order to investigate effect of ethanol extract of Rehmanniae radix(RREE) on electrophysiology of sinus node and papillary muscle. Rehmanniae radix is a herbal medicine which has been known to have diuretic, antipyretic, hemopoietic and cardiotonic effects. Action potentials were recorded by means of glass capillary microelectrode(technique) in rabbit sinoatrial nodal cells and papillary muscle cells which were superperfused with either tyrode solution or tyrode solutions containing different amount of RREE. The results obtained were as follows ; 1) In both central and peripheral nodal cells maximum diastolic potential (MDP) and amplitude of action potential (APA) were not affected by RREE. 2) Action potential duration as expressed $APD_{60}$(time to 60% repolarization) of central and peripheral pacemaker cells were significantly prolonged following perfusion with tyrode solution containing 0.1% RREE. 3) The rates of spontaneous firing from central pecemaker cell were decreased by RREE at concentration of 0.05% and 0. 1% while spontaneous rhythm of perinodal cell was decreased by 0.1% RREE. 4) The action potential duration of papillary muscle as expressed $APD_{60}$ were prolonged by 0.1% RREE.