Dynamic changes in left ventricular outflow tract flow velocities after amyl nitrite inhalation in hypertrophic cardiomyopathy

Hadjimiltiades, Stavros; Panidis, Ioannis P.; McAllister, Michael; Ross, John; Mintz, Gary S.

doi:10.1016/0002-8703(91)90675-8

Cited by 26 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Asym metrical hypertrophy, diastolic dysfunction and the dynamic LVOT gradient as the essen tial abnormalities are now readily detectable by cardiac ultrasound [14][15][16][17][18][19][20]. Markedly in creased outflow velocities localized within the LV cavity at rest or with provocation [15,19,21] have been found to represent the LVOT gradient. By the typical, late-peaking flow pro file [19] distinction of dynamic from both fixed LVOT obstruction, as in valvular aortic stenosis, and from mitral regurgitation is pos sible.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Intracavity Gradients: A ‘New’ Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Faber

Sürig²,

Dumitriu³

et al. 1994

Cardiology

View full text Add to dashboard Cite

The effect of provocation on left ventricular (LV) outflow was studied by continuous-wave Doppler echocardiography in 93 patients with LV hypertrophy (LVH), either due to pressure overload or hypertrophic cardiomyopathy (HCM), and in 39 healthy volunteers. In 50 patients with LVH, outflow acceleration (gradients ranging from 19 to 130 mm Hg) was induced or accentuated by at least one provocative situation independently of LVH aetiology. In normal persons LV outflow remained unchanged. Calcium antagonist treatment reduced outflow acceleration. It is concluded that dynamic LV gradients are a non-specific flow abnormality in the spectrum of LVH that merits consideration.

show abstract

Section: Discussionmentioning

confidence: 99%

Dynamic Intracavity Gradients: A ‘New’ Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Faber

Sürig²,

Dumitriu³

et al. 1994

Cardiology

View full text Add to dashboard Cite

show abstract

“…Hypovolemia and inotropic or β-adrenergic stimulation should be avoided in affected patients [36, 37]. Problems may arise in patients displaying acute signs of cardiac failure and cardiopulmonary polymorbidity.…”

Section: Discussionmentioning

confidence: 99%

Outflow Acceleration Assessed by Continuous-Wave Doppler Echocardiography in Left Ventricular Hypertrophy: An Analysis of 103 Consecutive Cases

Faber

Heemann²,

Sürig³

et al. 1998

Cardiology

View full text Add to dashboard Cite

The effect of provocation on left ventricular (LV) outflow was studied by continuous-wave Doppler echocardiography in 103 nonselected, consecutively enrolled patients with LV hypertrophy (LVH), either due to pressure overload (97 patients) or hypertrophic cardiomyopathy (HCM, 6 patients). In 34 patients with LVH, outflow acceleration (gradients ranging from 18 to 122 mm Hg) was induced or accentuated by the Valsalva maneuver after 1.6 mg nitroglycerine sublingually independent of LVH etiology. Factors associated with LV outflow acceleration were female sex, small body surface area and LV cavity size, increased relative wall thickness, LV contractility, and resting LV outflow velocity, mitral anulus calcifications and systolic anterior movement of the mitral valve. It is concluded that dynamic, intracavity LV gradients are a nonspecific flow abnormality that merit consideration because they can be frequently found in LVH patients.

show abstract

“…The increase of heart rate was similar during both provocation maneuvers. Even the application of short-acting amylnitrite may induce palpitations and mild light-headedness [13]. As compared with the tilt table test, another disadvantage of amylnitrite may be the short observation time of only 20 to 30 seconds.…”

Section: Discussionmentioning

confidence: 99%

Provocation of left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy

et al. 1996

View full text Add to dashboard Cite

Several provocation maneuvers are described in hypertrophic cardiomyopathy to Doppler echocardiographically distinguish the obstructive from the non obstructive type. No data are available about the value of orthostasis testing in comparison with nitrate application in this disease. In this study, 16 consecutive patients with hypertrophic cardiomyopathy were examined. 11 patients with hypertrophic cardiomyopathy were classified as obstructive, 5 patients with hypertrophic cardiomyopathy as non obstructive. Normal left ventricular outflow tract velocities as detected by the Doppler method were defined as < 2.0 m/s. Doppler echocardiographic measurements were performed after 10 minutes in supine position, within 10 minutes after head-up tilt and again, within 10 minutes in supine position. If systolic blood pressure during this examination exceeded 100 mm Hg 2.5 mg isosorbiddinitrate were sprayed sublingually. Measurements were done after 20 minutes in supine position and within 10 minutes after head-up tilt. Only in 7 of the 11 patients with hypertrophic obstructive cardiomyopathy maximal left ventricular outflow tract velocity in supine position measured > 2.0 m/s (2.2 +/- 0.8). During head-up tilt, all patients showed increased values (3.8 +/- 1.2 m/s). No differences in maximal left ventricular outflow tract velocity between head-up tilt and nitrate application in supine position (3.5 +/- 1.4 m/s) were present. All patients with hypertrophic non obstructive cardiomyopathy showed maximal left ventricular outflow tract velocities < 2.0 m/s in every step of the examination. Consequently, orthostasis testing was able to identify all patients with hypertrophic obstructive cardiomyopathy and demonstrated a diagnostic value similar to nitrate application.

show abstract

Dynamic changes in left ventricular outflow tract flow velocities after amyl nitrite inhalation in hypertrophic cardiomyopathy

Cited by 26 publications

References 20 publications

Dynamic Intracavity Gradients: A ‘New’ Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Dynamic Intracavity Gradients: A ‘New’ Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Outflow Acceleration Assessed by Continuous-Wave Doppler Echocardiography in Left Ventricular Hypertrophy: An Analysis of 103 Consecutive Cases

Provocation of left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy

Contact Info

Product

Resources

About

Dynamic changes in left ventricular outflow tract flow velocities after amyl nitrite inhalation in hypertrophic cardiomyopathy

Cited by 26 publications

References 20 publications

Dynamic Intracavity Gradients: A &lsquo;New&rsquo; Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Dynamic Intracavity Gradients: A &lsquo;New&rsquo; Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Outflow Acceleration Assessed by Continuous-Wave Doppler Echocardiography in Left Ventricular Hypertrophy: An Analysis of 103 Consecutive Cases

Provocation of left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy

Contact Info

Product

Resources

About

Dynamic Intracavity Gradients: A ‘New’ Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy

Dynamic Intracavity Gradients: A ‘New’ Hemodynamic Abnormality in the Spectrum of Secondary Left Ventricular Hypertrophy