Provocation of left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy. Comparison of orthostasis testing and nitrate application

International Journal of Cardiac Imaging
H DittrichK Bachmann

Abstract

Several provocation maneuvers are described in hypertrophic cardiomyopathy to Doppler echocardiographically distinguish the obstructive from the non obstructive type. No data are available about the value of orthostasis testing in comparison with nitrate application in this disease. In this study, 16 consecutive patients with hypertrophic cardiomyopathy were examined. 11 patients with hypertrophic cardiomyopathy were classified as obstructive, 5 patients with hypertrophic cardiomyopathy as non obstructive. Normal left ventricular outflow tract velocities as detected by the Doppler method were defined as < 2.0 m/s. Doppler echocardiographic measurements were performed after 10 minutes in supine position, within 10 minutes after head-up tilt and again, within 10 minutes in supine position. If systolic blood pressure during this examination exceeded 100 mm Hg 2.5 mg isosorbiddinitrate were sprayed sublingually. Measurements were done after 20 minutes in supine position and within 10 minutes after head-up tilt. Only in 7 of the 11 patients with hypertrophic obstructive cardiomyopathy maximal left ventricular outflow tract velocity in supine position measured > 2.0 m/s (2.2 +/- 0.8). During head-up tilt, all patients showed increase...Continue Reading

References

Nov 1, 1992·European Heart Journal·A WortmannK Bachmann
Jan 1, 1991·Journal of the American College of Cardiology·A P FitzpatrickR Sutton
Jan 1, 1991·Journal of the American College of Cardiology·P Kligfield
Jan 31, 1985·The New England Journal of Medicine·E J TopolN J Fortuin
Oct 1, 1995·Circulation·E D WigleW G Williams

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Citations

Aug 9, 2011·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·David ZemánekJosef Veselka
Sep 5, 2002·European Journal of Clinical Nutrition·M JoyanesA Marcos

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