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  • Title: [The significance of the chordal apparatus of the heart in forming "innocent" murmurs (clinical echocardiographic research)].
    Author: Onishchenko EF, Krylov AA.
    Journal: Ter Arkh; 1991; 63(4):17-22. PubMed ID: 2068672.
    Abstract:
    Clinical and echocardiographic studies were carried out in 100 young men (mean age 18.0 +/- 3.0 years) with "harmless" murmur (HM). 20 young men (mean age 17.0 +/- 2.0 years) were examined as control. In these men, murmur could not be detected both at rest and after 15 squattings and the hyperventilation test. No relationship was discovered between the murmur intensity and gravity of heart hyperdynamia, although in persons with HM, the predominance of hyperdynamia could be observed. It is believed that the intensity of HM is due to the morphofunctional features of the cardiac structures. The chordal apparatus of the heart is viewed as one of them. In 37% of persons with HM, echocardiography revealed a phenomenon of the "fluttering" chorda, which lies in diastolic-systolic hypermobility of one of the commonly attached chordae of the mitral valve because of its excessive length and weak tonic tension. That phenomenon is usually associated with so-called Steele's murmur. It is concluded that via the phenomenon of the "fluttering" of the chorda of the mitral valve there may occur labile and, in some cases, of "musical" non-regurgitation systolic murmur in local dysfunction of the papillary muscles.
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