Key result
Left ventricular outflow tract obstruction was present in 62% of HCM patients and was associated with higher pulmonary artery pressure (p=0.049) and greater left ventricular myocardial mass (p<0.001).
Why the study?
The prevalence and characteristics of left ventricular outflow tract obstruction across various phenotypic variants of hypertrophic cardiomyopathy were not well defined.
What are the echocardiographic characteristics and prevalence of left ventricular outflow tract obstruction in different phenotypes of hypertrophic cardiomyopathy?
Cross-Sectional (n=295)
What are the echocardiographic characteristics and prevalence of left ventricular outflow tract obstruction in different phenotypes of hypertrophic cardiomyopathy?
LVOT obstruction is highly prevalent (62%) in HCM patients and is significantly associated with concentric LV hypertrophy, higher pulmonary artery pressure, and greater LV myocardial mass.
LVOT obstruction patterns in HCM phenotypes warrant clinical caution; leaves open need for prospective validation before practice change.
Objective. To assess the prevalence and characteristics of left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy (HCM) with various phenotypic variants of hypertrophic expression considering data of 2D echocardiography and Doppler ultrasound. Material and methods. We examined 295 patients (183 (62%) men and 112 (38%) women) aged 18—88 years diagnosed with HCM. The diagnosis was based on thickness of one or more left ventricular segments ≥15 mm without any other cause of severe hypertrophy. Results. Mean duration of disease was 10 (5—15) years. LVOT or midventricular obstruction was identified in 183 (62%) patients. End-diastolic and end-systolic volumes, stroke volume and LV ejection fraction were similar in patients with/without obstruction. Diastolic dysfunction was more common in patients with obstruction (143 (61%), p=0.407). Pulmonary artery pressure was higher in patients with LVOT obstruction (p=0.049). Left ventricular myocardial mass and indexed left ventricular myocardial mass were higher in case of obstruction (364 (298—423) g and 179 (148—212) g/m2, p<0.001). Maximum LV wall thickness significantly differed depending on LVOT obstruction (p<0.001). The relationship between LVOT obstruction (at rest or under provocation) and certain morphological phenotype of myocardial hypertrophy was studied. Conclusion. LVOT and midventricular obstruction is associated with worse quality of life and survival in patients with HCM. Prevalence of obstructive HCM was more common in case of concentric LV hypertrophy.
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Игнатенко et al. (2024) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=295). Left ventricular outflow tract (LVOT) obstruction vs. No LVOT obstruction was evaluated on Prevalence of LVOT or midventricular obstruction. Left ventricular outflow tract obstruction was present in 62% of HCM patients and was associated with higher pulmonary artery pressure (p=0.049) and greater left ventricular myocardial mass (p<0.001).
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