The Mitral Valve in Hypertrophic Cardiomyopathy It's a Long Story

The short message is that the study by Maron et al definitively shows mitral leaflet elongation in a large study of patients with both overt and preclinical HCM.4 The study reinforces and extends the findings of previous angiographic, echocardiographic, and pathological studies. The results of this study imply a fundamental relationship between AML elongation, LVOT geometry, and LVOT obstruction. Recognition of abnormalities of the mitral leaflets or mitral apparatus has implications for the selection of the optimal treatment strategy for patients with obstructive HCM.4,19 Over the past 50 years, we have had to revise our thinking about HCM on numerous occasions.1 It is ironic that a disease that was first considered to be a mimicker of aortic stenosis may actually directly affect the mitral valve. However, given the twists and turns that have occurred in the history of our understanding and management of HCM, we can be sure that the final chapter has not yet been written on the mitral valve in patients with HCM. © 2011 American Heart Association, Inc.