Document Detail


Dynamic changes in left ventricular outflow tract flow velocities after amyl nitrite inhalation in hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  1672573     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Doppler echocardiography was performed in 21 patients with hypertrophic cardiomyopathy (HC), in nine patients with no evidence of left ventricular (LV) hypertrophy by two-dimensional echocardiography, and in five patients with systemic hypertension and concentric LV hypertrophy. The LV outflow tract (LVOT) peak velocity was recorded by continuous wave Doppler technique at rest and after amyl nitrite inhalation. The LVOT pressure gradient was calculated by the modified Bernoulli equation. A significant increase in heart rate and a drop in systolic blood pressure were observed in all patients after amyl nitrite inhalation; no adverse effects were encountered. The peak LVOT velocity and pressure gradient increased significantly after provocation in all patients, but the increase was much more pronounced in patients with HC (peak LVOT velocity increased from 2.2 +/- 0.8 to 4.3 +/- 1.0 m/sec and peak gradient increased from 22 +/- 17 to 78 +/- 36 mm Hg). The Doppler spectral signal in patients with HC demonstrated a characteristic contour, with peak velocity occurring in late systole. However, the observed increase in LVOT peak velocity was not statistically different between treated (with beta-blockers and calcium blockers) and untreated patients with HC. We conclude that LVOT peak velocity and pressure gradients in patients with HC can be readily assessed by Doppler echocardiography both at rest and after amyl nitrite inhalation. The dynamic changes in LVOT velocity induced by this provocation have certain characteristic features in obstructive HC but appear to be independent of the medical regimen used, at least in the dosages tested in our study.
Authors:
S Hadjimiltiades; I P Panidis; M McAllister; J Ross; G S Mintz
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  121     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-05-02     Completed Date:  1991-05-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1143-8     Citation Subset:  AIM; IM    
Affiliation:
Likoff Cardiovascular Institute, Hahnemann University Hospital, Philadelphia, PA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adrenergic beta-Antagonists / therapeutic use
Adult
Aged
Blood Flow Velocity / drug effects,  physiology
Cardiomyopathy, Hypertrophic / diagnosis*,  drug therapy,  physiopathology
Echocardiography
Echocardiography, Doppler
Hemodynamics / drug effects,  physiology
Humans
Male
Middle Aged
Nitrates / administration & dosage,  diagnostic use*
Pentanols / administration & dosage,  diagnostic use*
Ventricular Function, Left / drug effects*,  physiology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Nitrates; 0/Pentanols; 1002-16-0/amyl nitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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