| Non sustained ventricular tachycardia in hypertrophic cardiomyopathy and new ultrasonic derived parameters. | |
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MedLine Citation:
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PMID: 20362415 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The mechanism of sudden death in hypertrophic cardiomyopathy (HCM) is ventricular tachyarrhythmia emanating from myocyte disarray, fibrosis, and inhomogeneity in intramyocardial activation. Tissue synchronization imaging (TSI) allows the measurement of regional delay, while two-dimensional strain can be used to identify myocardial fibrosis. The aim of this study was to assess the relationship between new ultrasonically derived parameters and nonsustained ventricular tachycardia (NSVT) in patients with HCM. METHODS: Ninety-three patients with HCM (mean age, 36 +/- 16 years) and 30 patients with hypertension with secondary left ventricular (LV) hypertrophy (mean age, 42 +/- 10 years; 65% men) were studied. All underwent standard echocardiographic, TSI, and two-dimensional strain examinations. Patients were followed every 3 months for 2 years. Holter monitoring was performed every 3 months. The primary endpoint was the occurrence of NSVT. RESULTS: Twenty-four patients (26%) had >or=1 episode of NSVT. Patients with NSVT had a higher value of maximal LV thickness (22 +/- 6 vs 19 +/- 5 mm, P = .04). There were no significant associations between NSVT on Holter monitoring and LV outflow gradient, New York Heart Association class, syncope, and medical therapy. N-terminal pro-brain natriuretic peptide values were significantly (P = .01) higher in patients with NSTV (1034 +/- 1088 vs 561 +/- 593 pg/mL). Patients with HCM and NSVT had (1) similar values on TSI-studied parameters to patients without NSVT, (2) significant reductions in basal and mid septal strain and in basal anterior-septal strain, and (3) more frequently peak systolic strain >or= -10% (P < .0001). In multivariate analysis, the presence of >3 LV segments with longitudinal two-dimensional strain >or= -10% (sensitivity, 81%; specificity, 97.1%; area under the curve, 0.944; P < .0001) was an independent predictor of NSVT. CONCLUSIONS: Using a simple, inexpensive, easily available, and bedside-usable tool, it was possible to recognize with good sensitivity and specificity patients with HCM at higher risk for NSVT. |
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Authors:
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Giovanni Di Salvo; Giuseppe Pacileo; Giuseppe Limongelli; Luca Baldini; Alessandra Rea; Marina Verrengia; Antonello D'Andrea; Maria Giovanna Russo; Raffaele Calabrò |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2010-04-02 |
Journal Detail:
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Title: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Volume: 23 ISSN: 1097-6795 ISO Abbreviation: J Am Soc Echocardiogr Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-08-20 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: 581-90 Citation Subset: IM |
Copyright Information:
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Copyright 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Second University of Naples, Chair of Cardiology, Naples, Italy. giodisal@yahoo.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiomyopathy, Hypertrophic / complications* Echocardiography* Electrocardiography, Ambulatory Female Humans Male Middle Aged Prospective Studies Risk Factors Sensitivity and Specificity Tachycardia, Ventricular / diagnosis, etiology, ultrasonography* Young Adult |
| Comments/Corrections | |
Comment In:
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J Am Soc Echocardiogr. 2010 Jun;23(6):591-4
[PMID:
20497858
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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