Dynamic left ventricular obstruction: A potential cause of angina in end stage renal disease

Sharma, Rajan; Pellerin, Denis; Gaze, David; Mehta, Rajnikant; Gregson, Helen; Streather, Christopher P.; Collinson, Paul; Brecker, Stephen

doi:10.1016/j.ijcard.2005.09.023

Cited by 7 publications

(8 citation statements)

References 28 publications

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“…Dynamic LVOT obstruction has also been shown to occur during exercise in the absence of HCM [17], and is now being investigated as a potential cause of ischaemia in diabetes [18], renal failure [19] and tako-tsubo cardiomyopathy [20]. Moreover, it is a potentialsubstrate for dyspnoea in patients with HFNEF.…”

Section: Potential Impact Of Bsh During Systolementioning

confidence: 99%

Basal Septal Hypertrophy

Kelshiker¹,

Mayet²,

Unsworth³

et al. 2014

CCR

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A significant clinical problem is patients presenting with exercise-limiting dyspnoea, sometimes with associated chest pain, in the absence of detectable left ventricular (LV) systolic dysfunction, coronary artery disease, or lung disease. Often the patients are older, female, and have isolated basal septal hypertrophy (BSH), frequently on a background of mild hypertension. The topic of breathlessness in patients with clinical heart failure, but who have a normal ejection fraction (HFNEF) has attracted significant controversy over the past few years. This review aims to analyse the literature on BSH, identify the possible associations between BSH and HFNEF, and consequently explore possible pathophysiological mechanisms whereby clinical symptoms are experienced.

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Section: Potential Impact Of Bsh During Systolementioning

confidence: 99%

Basal Septal Hypertrophy

Kelshiker¹,

Mayet²,

Unsworth³

et al. 2014

CCR

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“…Other authors [15][16][17] have linked the development of a dynamic outflow tract gradient to negative outcomes. Sharma et al [15] studied 125 renal transplant candidates who underwent DSE and coronary angiography.…”

Section: Discussionmentioning

confidence: 99%

“…Sharma et al [15] studied 125 renal transplant candidates who underwent DSE and coronary angiography. They found that dynamic left ventricular outflow obstruction occurs in 26% of end stage renal disease patients with angina.…”

Section: Discussionmentioning

confidence: 99%

Dynamic left ventricular outflow tract obstruction induced by dobutamine stress echocardiography leading to myocardial ischemia and infarction

Makaryus

Meraj

Rosman

2006

Int J Cardiovasc Imaging

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Left ventricular outflow tract (LVOT) obstruction occurring during dobutamine stress echocardiography (DSE) occurs in approximately 15-20% of patients undergoing DSE. The clinical significance and mechanism of LVOT obstruction has been debated, but is now generally felt to result from the pharmacological effects of dobutamine in increasing inotropy and causing peripheral vasodilation. It must be realized that in rare instances, ischemia may occur and lead to wall motion abnormalities and eventually myocardial infarction. We present the case of a 70-year-old asymptomatic woman who underwent a routine pre-operative cardiac stress evaluation and was found to develop a dynamic outflow tract obstruction leading to myocardial ischemia and infarction.

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“…Recently, 12 the dobutamine stress echocardiography was used to provoke LVOTG in nephrological patients without obstruction at rest. Importantly, however only one‐third of these patients had been on HD while the remaining patients were free from preload fluctuations.…”

Section: The Selection Of Stress Test To Provoke Lvotg In Hemodialyzementioning

confidence: 99%