Introduction
Methods
Study subjects
Valuable | Value (n = 73) |
---|---|
Age (years) | 69 ± 15 |
Male | 28 (38%) |
Follow-up periods (months) | 45 ± 38 |
Hypertension | 49 (66%) |
Dyslipidemia | 30 (41%) |
Diabetes mellitus | 10 (14%) |
Coronary artery disease | 23 (31%) |
Chronic kidney disease | 18 (24%) |
Chronic lung disease | 18 (24%) |
Anemia | 32 (43%) |
Paroxysmal atrial fibrillation or paroxysmal supra ventricular tachycardia | 22 (30%) |
Cerebral infarction | 3 (4%) |
Paced lead | 3 (4%) |
Infective endocarditis | 2 (3%) |
Admission for heart failure | 5 (7%) |
Death | 9 (12%) |
Transthoracic echocardiographic examinations
Statistical analysis
Results
Valuable | Value (n = 73) |
---|---|
Heart rate, beats per min | 77 ± 18 |
Systolic anterior motion | 67 (91%) |
Severe systolic anterior motion | 45 (61%) |
Hyperkinetic LV (LV ejection fraction >0.70) | 46 (62%) |
Mitral annular calcification | 29 (39%) |
LV geometry | |
End-diastolic diameter, mm | 41 ± 6 |
End-systolic diameter, mm | 24 ± 5 |
Septal wall thickness, mm | 16 ± 4 |
Posterior wall thickness, mm | 12 ± 3 |
LV systolic parameter | |
Ejection fraction, % | 74 ± 9 |
LV diastolic parameters | |
E wave, cm/s | 110 ± 43 |
A wave, cm/s | 107 ± 43 |
Deceleration time, ms | 229 ± 76 |
E/e′ | 15 ± 7 |
Systolic pulmonary arterial pressure, mmHg | 34 ± 14 |
Left atrial parameters | |
Left atrial diameter, mm | 42 ± 9 |
Left atrial area index, cm2/m2
| 24 ± 6 |
Aortic valve regurgitation (none/mild/moderate/severe) | 43/28/2/0 |
Mitral valve regurgitation (none/mild/moderate/severe) | 3/38/22/10 |
Tricuspid valve regurgitation (none/mild/moderate/severe) | 3/65/4/1 |
Cause of LVOTO
Clinical diagnosis |
n = 73 |
---|---|
Hypertrophic obstructive cardiomyopathy | 54 (74%) |
Hypertensive left ventricular hypertrophy | 7 (9%) |
Post-cardiac surgery (4 of MV repair, 1 of MV replacement) | 5 (7%) |
Sigmoid septum | 3 (4%) |
Hyperkinetic heart | 2 (3%) |
Takotsubo cardiomyopathy | 1 (1.5%) |
Discrete subaortic stenosis | 1 (1.5%) |
HOCM | LVH | Post surgery | Sigmoid septum | Hyperkinetic LV | Takotsubo cardiomyopathy | Sub-aortic membrane | |
---|---|---|---|---|---|---|---|
n | 54 | 7 | 5 | 3 | 2 | 1 | 1 |
Age, years | 69 ± 13 | 81 ± 14 | 66 ± 18 | 85 ± 8 | 56 ± 1 | 88 | 31 |
Men | 21 | 3 | 3 | 0 | 1 | 0 | 0 |
Hypertension | 36 | 7 | 3 | 2 | 1 | 0 | 0 |
Dyslipidemia | 21 | 4 | 2 | 2 | 0 | 0 | 0 |
DM | 6 | 3 | 1 | 0 | 0 | 0 | 0 |
PAF, PSVT | 18 | 3 | 0 | 1 | 0 | 0 | 0 |
Paced lead | 2 | 0 | 1 | 0 | 0 | 0 | 0 |
IE or suspected | 2 | 0 | 0 | 0 | 0 | 0 | 0 |
Hb, mg/dl | 11.8 ± 2.1 | 10.0 ± 1.8 | 12.8 ± 2.1 | 12.5 ± 0.4 | 10.9 ± 2.4 | 9.5 | 11.9 |
Heart failure | 4 | 1 | 0 | 0 | 0 | 0 | 0 |
Cardiac death or suspected | 1 | 2 | 0 | 0 | 0 | 0 | 0 |
Medical | 49 | 7 | 4 | 2 | 0 | 1 | 1 |
β-blocker | 35 | 4 | 4 | 2 | – | 1 | 1 |
Disopyramide | 13 | 0 | 0 | 0 | – | 0 | 0 |
Verapamil | 6 | 0 | 0 | 0 | – | 0 | 0 |
Amiodalone | 6 | 0 | 0 | 0 | – | 0 | 0 |
Diuretic | 14 | 1 | 1 | 0 | – | 0 | 0 |
Antiplatelet | 27 | 1 | 4 | 2 | – | 1 | 1 |
Anticoagulant | 9 | 1 | 1 | 0 | – | 0 | 0 |
Ablation (+medication) | 7 (6) | 0 | 0 | 0 | 0 | 0 | 0 |
Surgery (+medication) | 0 | 0 | 0 | 0 | 0 | 0 | 1 (1) |
Treatment
Echocardiographic parameters classified by clinical diagnosis
HOCM | LVH | Post surgery | Sigmoid septum | Hyperkinetic LV | Takotsubo cardiomyopathy | Sub-aortic membrane | |
---|---|---|---|---|---|---|---|
n
| 54 | 7 | 5 | 3 | 2 | 1 | 1 |
HR (bpm) | 76 ± 16 | 81 ± 13 | 66 ± 18 | 95 ± 18 | 56 ± 1 | 87 | 80 |
Severe SAM | 33 | 3 | 1 | 1 | 2 | 1 | 0 |
MAC | 25 | 4 | 0 | 0 | 0 | 0 | 0 |
LVDd (mm) | 42 ± 6 | 37 ± 6 | 45 ± 5 | 34 ± 3 | 40 ± 13 | 47 | 43 |
LVDs (mm) | 24 ± 5 | 21 ± 5 | 28 ± 3 | 24 ± 1 | 21 ± 1 | 33 | 28 |
IVS th (mm) | 17 ± 4 | 14 ± 2 | 12 ± 1 | 11 ± 3 | 10 ± 2 | 12 | 11 |
PW th (mm) | 12 ± 2 | 14 ± 3 | 11 ± 1 | 10 ± 3 | 9 ± 1 | 10 | 11 |
LVEF (%) | 76 ± 8 | 79 ± 8 | 66 ± 11 | 66 ± 5 | 79 ± 7 | 57 | 65 |
TMF, E, (cm/s) | 106 ± 43 | 118 ± 27 | 132 ± 82 | 98 ± 23 | 126 ± 4 | 115 | 118 |
TMF, A (cm/s) | 101 ± 35 | 138 ± 18 | 88 ± 36 | 81 ± 10 | 171 | 82 | |
TMF, DT (ms) | 225 ± 70 | 248 ± 108 | 280 ± 77 | 134 ± 19 | 346 | 191 | |
E/e′ | 15.0 ± 8 | 18.8 ± 9.1 | 14.3 ± 4.4 | 10.0 ± 4.0 | 10.0 ± 1.0 | 14.7 | 11.2 |
SPAP (mmHg) | 33 ± 13 | 45 ± 21 | 30 ± 6 | 40 ± 17 | 32 | 45 | |
LAD (mm) | 43 ± 8 | 39 ± 9 | 42 ± 8 | 32 ± 7 | 42 ± 6 | 43 | 33 |
LA area, cm2
| 25 ± 6 | 21 ± 6 | 24 ± 5 | 15 ± 8 | 20 ± 4 | 30 | 13 |
Severity of AR (none/mild/moderate/severe) | 34/19/1/0 | 4/3/0/0 | 1/4/0/0 | 1/2/0/0 | 2/0/0/0 | 1/0/0/0 | 0/0/1/0 |
Severity of MR (none/mild/moderate/severe) | 3/33/14/4 | 0/2/1/4 | 0/0/4/1 | 0/1/2/0 | 0/1/1/0 | 0/0/0/1 | 0/1/0/0 |
Severity of TR (none/mild/moderate/severe) | 3/48/3/0 | 0/6/0/1 | 0/5/0/0 | 0/2/1/0 | 0/2/0/0 | 0/1/0/0 | 0/1/0/0 |