Gradient variability in hypertrophic cardiomyopathy: New insights from computer ‐assisted, high fidelity, rest and exercise hemodynamic analysis

ConclusionsOur study suggests that computer ‐assisted analysis of hemodynamic variability in HCM may prove useful in characterizing the severity of obstruction. Further study is warranted to confirm the reproducibility and utility of this finding in a population with clinically significant exercise‐induced gradients.
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research

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Hypertrophic cardiomyopathy affects 0.5% of the population. Advanced testing is considered, including cardiac catheterization, endomyocardial biopsy, and cardiopulmonary exercise testing. Right and left heart catheterization provides essential hemodynamic data, identifies patients who might benefit from septal reduction therapy, and assesses for comorbidities. Pathologic analysis reveals ventricular hypertrophy, myocardial disarray, and endocardial and interstitial fibrosis. Routine endomyocardial biopsy is not recommended unless other conditions that cause hypertrophy need to be ruled out. Cardiopulmonary exercise testing...
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research
LVOT gradient in HOCM – Doppler echocardiogram Left ventricular outflow tract gradient in hypertrophic obstructive cardiomyopathy Left ventricular outflow tract gradient (LVOT) in hypertrophic obstructive cardiomyopathy (HOCM) is usually  measured from the apical five chamber view (apical 5C) in echocardiography. Initially the apical 5C view is obtained and then the colour Doppler flow mapping (CFM) is done to locate the flow in LVOT. Continuous wave (CW) Doppler cursor is then aligned along the LVOT colour jet of HOCM. The CW jet in HOCM is described as dagger shaped or sickle shaped, unlike the symmetrical ton...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Echocardiogram Library Echocardiography Dynamic variation of LVOT gradient in hypertrophic cardiomyopathy Source Type: blogs
CONCLUSIONS: Elevated RAP in patients with HCM is associated with left-sided heart failure and is an independent predictor of all-cause mortality and new-onset AF. PMID: 29526913 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Abstract AimsPercutaneous septal reduction therapy by either alcohol or nonalcohol agents is an alternative approach to surgery in drug‐refractory symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). Nonalcohol agents have some advantages and disadvantages over alcohol during the procedure. Nowadays, a novel non‐alcohol agent, named as Ethylene‐vinyl alcohol (EVOH) copolymer (Onyx® and Squid®), is used during septal ablation. Thus, in this study, we aimed to evaluate both acute and long‐term efficacy and safety profile of EVOH during septal ablation in HOCM. Methods and resultsA total o...
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research
Left ventricular hypertrophy (LVH) is often encountered cardiac disorder with heterogeneous clinical presentation and course. Although unexplained LVH is the hallmark of hypertrophic cardiomyopathy, differential diagnosis of secondary cardiomyopathies with LVH has been needed. Because, disease-oriented treatments have made progress. For example, the enzyme replacement therapy for Anderson-Fabry disease promises the modification of natural course of disease. In the first half of this presentation, we will overview the clinical significance of diagnostic procedures such as medical history, physical examination, laboratory da...
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - Category: Cardiology Authors: Tags: Images in Intervention Source Type: research
ConclusionsDoppler echocardiography under‐diagnoses and underestimates severity of LVMCO in symptomatic HCM patients. Recognition of abrupt mid‐systolic flow cessation and invasive measurements may improve detection of LVMCO in HCM.
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research
Conclusions— Pulmonary hypertension was common in obstructive hypertrophic cardiomyopathy patients with advanced heart failure. Although possibly a contributor to preoperative heart failure, pulmonary hypertension did not significantly influence clinical and surgical outcome. Notably, a novel patient subgroup was identified with resting invasive hemodynamics consistent with pulmonary vascular disease.
Source: Circulation: Heart Failure - Category: Cardiology Authors: Tags: Pathophysiology, Cardiomyopathy Original Articles Source Type: research
ConclusionsIn this case report and literature review, we highlight an unusual but important association that can lead to symptomatic worsening of angina in young patients with hypertrophic cardiomyopathy owing to coronary steal phenomena.
Source: Journal of Medical Case Reports - Category: Journals (General) Source Type: research
Here is all you wanted to know about alternans: Traube’s pulse, total pulsus alternans, diastolic pulsus alternans, right ventricular pulsus alternans, biventricular pulsus alternans and electrical alternans! Traube’s pulse – pulsus alternans Pulsus alternans or Traube’s pulse was described by Ludwig Traube in 1872 [1]. Pulsus alternans is nothing but alternating pulses having different volumes and is a feature of left ventricular dysfunction. It is well known that pulsus alternans can be augmented by a premature ventricular contraction [2]. A rare case of pulsus alternans due to 2:1 left bundl...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology biventricular pulsus alternans Brody's effect diastolic pulsus alternans electrical alternans right ventricular pulsus alternans total pulsus alternans Traube's pulse Source Type: blogs
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