• Korean Journal of Radiology
• /
• v.22 no.10
• /
• pp.1609-1618
• /
• 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.

• YAKHAK HOEJI
• /
• v.29 no.4
• /
• pp.199-205
• /
• 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 Veterinary Clinics
• /
• v.34 no.4
• /
• pp.279-282
• /
• 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.

• The Journal of the Korean dental association
• /
• v.16 no.7 s.110
• /
• pp.531-536
• /
• 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
• /
• v.23 no.6
• /
• pp.1128-1138
• /
• 1990

The mitral valve is not a simple but a complex structure, mitral valve complex. This complex is composed of mitral orifice, annulus, valve leaflet, chordae tendineae and papillary muscles. There were many controversies about this structures. We studied mitral valve complex in 63 cases of normal Korean adults, such as the circumference of mitral annulus, the intercommissural diameter, height and breadth of the cusps, including commissure, the ratio of rough to clear zone, breadth of the achordal zone, the number of scallops of posterior cusp, the number, length and the pattern of arrangement of the several types of chordae, the number and morphological characteristics of papillary muscles.

• Journal of Chest Surgery
• /
• v.45 no.6
• /
• pp.401-403
• /
• 2012

A 29-year-old man was admitted for abrupt dyspnea and hemoptysis. An echocardiogram revealed severe mitral regurgitation due to papillary muscle rupture for which an emergency mitral valve replacement operation was performed 4 days after admission. Herein, we report our experience with this case along with a review of the literature.

• Korean Journal of Veterinary Research
• /
• v.41 no.3
• /
• pp.311-317
• /
• 2001

In this work we have investigated the physiological effects of $MgCl_2$ in isolated atrium, papillary muscle, perfused heart and anesthesized guinea pig, The addition or infusion of $MgCl_2$ (0~20 mM or mg/kg) to perfused hearts and to anesthesized guinea pigs induced a marked and dose-dependent negative chronotropic effect. The sinoatrial node automaticity could also be reduced by $MgCl_2$. The addition of $MgCl_2$to isolated atria and to papillary muscles induced a marked and dose-dependent negative inotropic effect. The threshold voltage could be increased by $MgCl_2$in papillary muscle. Increasing $MgCl_2$ shortened the action potential duration (APD) in dose-dependent manner at 30% ($APD_{30}$) and 90% repolarization ($APD_{90}$) measured with conventional microelectrode technique in papillary muscle. In anesthesized guinea pig, the magnesium infusion resulted in a dose-dependent drop in blood pressure. These results suggested that magnesium is closely associated with cardiac physiological condition and exerts antiarrhythmic activities.

• Journal of the Institute of Electronics Engineers of Korea SC
• /
• v.37 no.5
• /
• pp.56-62
• /
• 2000

In this paper, an automatic extraction of the blood flow contour from cardiac MRI is proposed. By using the GVF snake which has wider capture range than the conventional snake, and by automatically generating the initial points along the outside of the contour of the zero GVF field in the edge image of the cardiac MRI, the blood flow contour can be automatically extracted, even when the contours have boundary concavities due to the papillary muscles, without any manual initialization of the experts. Experiments are conducted on the various real cardiac MRIs including noise and papillary muscles, and the proposed method is proved to be efficient in automatic extraction of the blood contours even if they have the boundary concavities.

• YAKHAK HOEJI
• /
• v.27 no.2
• /
• pp.155-161
• /
• 1983

The rates of deterioration of contractile forces of isolated hearts from ginseng component treated rats were determined. Rat papillary muscles were also used to study the influence of ginseng on the mechanical performance of heart. Rats weighing 200-300g were administered orally with ginseng ethanol extract (100mg/kg/day), ginseng total saponin (50mg/kg/day) and ginsenoside Rbl (5mg/kg/ day) for a week respectively. The isolated hearts from rats were perfused with Krebs-Henseleit solution by Langendorff perfusion apparatus. The force-velocity relation was clearly seen with the load-generator equipped isotonic shortening recording apparatus. The control group was only able to maintain 60% of their initial contractile forces after 120 minutes of perfusion, whereas ginseng ethanol extract treated group was able to sustain nearly their initial strength even after 120 minutes of perfusion. The similar effects were seen in the hearts treated with total ginseng saponin and ginsenoside Rb$_{1}$. Ginseng ethanol extract did alter mechanical performance of rat ventricular myocardium. It increased both maximum velocity(Vmax) of isotonic shortening and isometric force (P$_{0}$) and showed increased velocity of shortening significantly (P<0,05) at any one afterload.d.

• Journal of Chest Surgery
• /
• v.16 no.3
• /
• pp.272-280
• /
• 1983

With respect to controversial opinions concerning the nitroglycerin effects on cardiac muscle the direct nitroglycerin actions were thoroughly studied in isolated papillary muscles, atrial preparations and coronary strips of rabbits. Isometric active tension of papillary muscles developed at $35^{\circ}C$ upon electric stimulation at a rate of 60/min, was not affected by nitroglycerin up to a concentration of 10mg/L Higher concentrations of nitroglycerin, however, reduced action tension progressively. This depression of mechanical activity is accompanied by a decrease in oxygen consumption as measured by means of a flow respirometer. Resting oxygen uptake, on the other hand, remained unchanged. Similarly active tension of spontaneously beating atrial preparations also declined at a nitroglycerin concentration of more than 10 mg/L, whereas the sinus frequency did not change up to 40 mg/L. In contrast, rabbit coronary strips are much more sensitive to nitroglycerin and relax in a range of 10-100 ug/L of nitroglycerin concentration. The results indicate that the pharmacologic effects of nitroglycerin in coronary disease are due to vascular actions, because the plasma levels of nitroglycerin attainable in human therapy are not sufficiently high to directly influence the myocardium.