| Sublingual isosorbide dinitrate for the detection of obstruction in hypertrophic cardiomyopathy. | |
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MedLine Citation:
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PMID: 21821607 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIMS: Hypertrophic cardiomyopathy (HCM) is predominantly associated with left ventricular outflow tract (LVOT) obstruction. The assessment of the obstruction with a provoking test should be a routine part of HCM evaluation. The aim of the study was to determine the utility of a sublingual spray application of isosorbide dinitrate (ISDN) for detection of an obstruction. METHODS AND RESULTS: We have prospectively analysed 77 consecutive HCM patients, measuring the LVOT gradient at rest, using the sublingual spray application of ISDN (2.5 mg; after 2, 5, and 10 min), and with exercise echocardiography. An obstruction was defined as a gradient ≥30 mmHg. An obstruction was present in 15 patients (19%) at rest, in 42 patients (55%) after ISDN, and in 55 patients (71%) after exercise. The ISDN test had a sensitivity of 76% and the specificity of 100% relative to exercise echocardiography, while at-rest measurements had a sensitivity of 27% and a specificity of 100%. The chronological difference in the prevalence of obstructions during the ISDN test was statistically significant (P < 0.05); at ISDN plus 2 min, obstructions were seen in only 29 patients (38%, gradient 28.8 ± 25.0 mmHg), however, at ISDN plus 5 and 10 min, obstructions were found in 42 patients (55%, gradient 44.5 ± 39.6 mmHg). CONCLUSION: The ISDN test is a reliable screening method for the detection of an HCM obstruction, however, the measurement should be delayed 5-10 min after the application of ISDN. Patients with negative ISDN tests should undergo exercise echocardiography. |
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Authors:
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David Zemánek; Pavol Tomasov; Stanislava Homolová; Katerina Linhartová; Josef Veselka |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-4 |
Journal Detail:
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Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: - ISSN: 1532-2114 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Cardiology, University Hospital Motol, First and Second Medical School of Charles University, V Uvalu 84, 150 21 Prague, Czech Republic. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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