| Diagnostic value of left ventricular outflow area in patients with hypertrophic cardiomyopathy: a real-time three-dimensional echocardiographic study. | |
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MedLine Citation:
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PMID: 18325733 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Earlier studies demonstrated the ability of real-time 3-dimensional (3D) echocardiography (3DE) to measure left ventricular outflow tract (LVOT) area (A(LVOT)) in patients with hypertrophic cardiomyopathy (HCM). However, its clinical value is unknown. OBJECTIVE: We sought to investigate the feasibility and accuracy of real-time 3DE-derived A(LVOT) to diagnose significant LVOT obstruction in a large number of patients with HCM. METHODS: A total of 162 patients with HCM had 3DE by using a volumetric system. The smallest A(LVOT) during systole was determined by moving a 2-dimensional plane in 3D space. The pressure gradient across LVOT was assessed by continuous wave Doppler method. Provocation was performed in patients without significant LVOT obstruction (pressure gradient across LVOT < 50 mm Hg) at rest. RESULTS: Twenty (12%) patients with poor image quality of 3DE were excluded; 16 (28%) patients with a volumetric system, but only 4 (4%) patients with commercial equipment (P < .001). In the remaining 142 patients, A(LVOT) inversely correlated with pressure gradient across LVOT both at rest (r = 0.82, P < .001) and after provocation (r = 0.60, P < .001). The value of A(LVOT) less than 0.85 cm(2) and less than 2.0 cm(2) predicted resting and provokable LVOT obstruction with sensitivity of 87% and 81%, and specificity of 77% and 90%, respectively. CONCLUSIONS: Real-time 3DE measurement of A(LVOT) was successful in diagnosing and quantifying LVOT obstruction at rest and after provocation in a large number of patients with HCM. |
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Authors:
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Shota Fukuda; Harry M Lever; William J Stewart; Hung Tran; Jong-Min Song; Mi-Seong Shin; Neil L Greenberg; Nozomi Wada; Yoshiki Matsumura; Manatomo Toyono; Nicholas G Smedira; James D Thomas; Takahiro Shiota |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-03-06 |
Journal Detail:
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Title: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Volume: 21 ISSN: 1097-6795 ISO Abbreviation: J Am Soc Echocardiogr Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-01 Completed Date: 2008-08-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: United States |
Other Details:
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Languages: eng Pagination: 789-95 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Flow Velocity / physiology Cardiomyopathy, Hypertrophic / complications, physiopathology, ultrasonography* Diagnosis, Differential Echocardiography, Three-Dimensional / methods* Feasibility Studies Female Heart Ventricles / physiopathology, ultrasonography* Humans Male Middle Aged Reproducibility of Results Severity of Illness Index Time Factors Ventricular Function, Left / physiology* Ventricular Outflow Obstruction / etiology, physiopathology, ultrasonography* Ventricular Pressure / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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