Medical and transcatheter therapies significantly improved or reduced left ventricular outflow tract obstruction in 93% of patients across diverse etiologies at a mean follow-up of 44 months.
Observational (n=73)
No
LVOTO has diverse causes beyond HOCM, and significant improvement in pressure gradients can be achieved in the vast majority of patients with appropriate medical or transcatheter management.
BACKGROUND: Left ventricular outflow tract obstruction (LVOTO) occurs from not only obstructive hypertrophic cardiomyopathy but also other conditions such as sigmoid septum or post mitral valve repair. However, the changes of the LVOT pressure gradient (LVOT PG) in LVOTO with various conditions remain unclear. METHODS: The clinical characteristics and echocardiographic parameters of 73 patients with LVOT PG ≥50 mmHg at rest on Doppler ultrasound were retrospectively investigated. RESULTS: In these patients (age 69 ± 15 years, 38% male), high prevalences of hypertension (66%) and anemia (43%) were observed. The most frequent clinical disease causing LVOTO was hypertrophic obstructive cardiomyopathy (HOCM) (74%). There were other conditions, including hypertensive left ventricular hypertrophy (9%), post-open heart surgery (7%), sigmoid septum (4%), hyperkinetic LV (3%), takotsubo cardiomyopathy (1.5%), and discrete subaortic membrane (1.5%). Significant improvement or reduction of LVOTO was observed in 93% of cases at follow-up (mean 44 months) echocardiography compared with the initial one with the use of medications and transcatheter procedures. CONCLUSIONS: The causes of LVOTO are diverse. However, the occurrence of LVOTO might depend on the coexistence of primary morphological LV characteristics and hemodynamic LV status. Specific factors causing LVOTO need to be investigated, and efforts for improvement of each individual status by the appropriate approach are required.
Kobayashi et al. (Mon,) conducted a observational in Left ventricular outflow tract obstruction (LVOTO) (n=73). Medications and transcatheter procedures vs. Initial echocardiography (baseline) was evaluated on Improvement or reduction of LVOTO at follow-up. Medical and transcatheter therapies significantly improved or reduced left ventricular outflow tract obstruction in 93% of patients across diverse etiologies at a mean follow-up of 44 months.