February 1, 1986Circulation
Left ventricular pulsus alternans in patients with hypertrophic cardiomyopathy and severe obstruction to left ventricular outflow.
Key result
Left ventricular pulsus alternans was observed in 17.5% (35/200) of patients with hypertrophic cardiomyopathy and severe outflow gradients, and was abolished following surgical myectomy.
Why the study?
Is left ventricular pulsus alternans associated with severe left ventricular outflow gradients in patients with hypertrophic cardiomyopathy?
Population
200 patients with hypertrophic cardiomyopathy undergoing hemodynamic study.
Design
Cohort
Authors
Discussion
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Member takes
Implication
May indicate severe obstruction in hypertrophic cardiomyopathy; leaves open its prognostic value and role in management.
Study Design
Type
Observational (n=200)
Structured PICO
Is left ventricular pulsus alternans associated with severe left ventricular outflow gradients in patients with hypertrophic cardiomyopathy?
P
Population
200 patients with hypertrophic cardiomyopathy undergoing hemodynamic study.
I
Intervention
Hemodynamic study with provocative maneuvers (a subset of 10 patients underwent ventricular septal myotomy-myectomy).
O
Outcome
Presence of left ventricular pulsus alternans (LVPA) and its association with left ventricular outflow gradients.surrogate
Left ventricular pulsus alternans is a common finding in hypertrophic cardiomyopathy with severe outflow obstruction and is abolished by surgical relief of the gradient, suggesting it reflects inadequate contractile function against high systolic pressures.
Cite This Study
Cannon et al. (1986) conducted an observational in Hypertrophic cardiomyopathy (n=200). Ventricular septal myotomy-myectomy was evaluated on Presence of left ventricular pulsus alternans (LVPA). Left ventricular pulsus alternans was observed in 17.5% (35/200) of patients with hypertrophic cardiomyopathy and severe outflow gradients, and was abolished following surgical myectomy.