Prognostic impact of mitral L-wave in patients with hypertrophic cardiomyopathy without risk factors for sudden cardiac death

Sugiura, Yuki; Morimoto, Ryo; Aoki, Soichiro; Yamaguchi, Shogo; Haga, Tomoaki; Kuwayama, Tasuku; Yokoi, Tsuyoshi; Hiraiwa, Hiroaki; Kondo, Toru; Watanabe, Naoki; Kano, Naoaki; Fukaya, Kenji; Sawamura, Akinori; Okumura, Takahiro; Murohara, Toyoaki

doi:10.1007/s00380-019-01440-y

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…patterns of 20% and 30%, respectively [20]. In a sample of younger subjects affected by HCM with a low sudden cardiac death (SCD) risk score and normal LVEF, the reported rate of L wave prevalence was 15.1% [10]. Recently, in a cohort of 445 patients (both in SR and AF) with the first clinical diagnosis of HCM, Saito et al reported a higher prevalence of the L wave (32.4%).…”

Section: Pathophysiologymentioning

confidence: 99%

“…In 2008, Lam et al reported in a population of subjects in SR with LVH and preserved left ventricular ejection fraction (LVEF) a prevalence of triphasic transmitral flow and mid-diastolic mitral annular velocity (L’ wave) patterns of 20% and 30%, respectively [ 20 ]. In a sample of younger subjects affected by HCM with a low sudden cardiac death (SCD) risk score and normal LVEF, the reported rate of L wave prevalence was 15.1% [ 10 ]. Recently, in a cohort of 445 patients (both in SR and AF) with the first clinical diagnosis of HCM, Saito et al reported a higher prevalence of the L wave (32.4%).…”

Section: Epidemiologymentioning

confidence: 99%

“…The common final pathway of advanced diastolic dysfunction is the increased LV filling pressure with pulmonary vascular congestion so the aim of diastolic evaluation is to know if the filling pressure is above normal. The connection between L events and increased filling pressure was mostly based on indirect markers, E/E’ ratio, while invasive measurement often failed to demonstrate a significant correlation [ 10 , 37 , 38 ].…”

Section: L Events In Sinus Rhythmmentioning

confidence: 99%

“…The role of the L wave in HCM patients with low HCM risk–SCD score and good functional status [ 10 ] was studied. The primary endpoints were SCD and lethal arrhythmias.…”

Section: L Events In Hypertrophic Cardiomyopathymentioning

confidence: 99%

“…Nonetheless, occasionally, we can observe mid-diastolic events that we call “L events” during the echocardiographic examination ( Table 1 , Figure 1 ). Among these, mid-diastolic transmitral flow velocity (L wave) is the most studied [ 10 , 11 , 12 , 13 , 14 ] ( Figure 2 ). It was called “L” because it follows the K and J pulmonary vein flow phases (corresponding to the S and D waves of pulmonary venous flow Doppler sampling).…”

Section: Introductionmentioning

confidence: 99%

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Mid-Diastolic Events (L Events): A Critical Review

Virgilio

Monitillo

Santoro

et al. 2021

JCM

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Mid-diastolic events (L events) include three phenomena appreciable on echocardiography occurring during diastasis: mid-diastolic transmitral flow velocity (L wave), mid-diastolic mitral valve motion (L motion), and mid-diastolic mitral annular velocity (L’ wave). L wave is a known marker of advanced diastolic dysfunction in different pathological clinical settings such as left ventricle and atrial remodeling, overloaded states, and cardiomyopathies. Patients with L events have poor outcomes with a higher risk of developing heart failure symptoms and arrhythmic complications, including sudden cardiac death. The exact mechanism underlying the genesis of mid-diastolic events is not fully understood, just as the significance of these events in healthy young people or their presence at the tricuspid valve level. We also report an explicative case of a patient with L events studied using speckle tracking imaging of the left atrium and ventricle at the same reference heartbeat supporting the hypothesis of a post-early diastolic relaxation or a “two-step” ventricular relaxation for L wave genesis. Our paper seeks to extend knowledge about the pathophysiological mechanisms on mid-diastolic events and summarizes the current knowledge.

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Section: Pathophysiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: L Events In Sinus Rhythmmentioning

confidence: 99%

“…The role of the L wave in HCM patients with low HCM risk–SCD score and good functional status [ 10 ] was studied. The primary endpoints were SCD and lethal arrhythmias.…”

Section: L Events In Hypertrophic Cardiomyopathymentioning

confidence: 99%