Sitting maneuver to uncover latent left ventricular outflow tract obstruction in patients without hypertrophic cardiomyopathy

被引：0

作者：

Sekine, Ayako ^{[1
]}

Watanabe, Takamoto ^{[1
,2
,3
]}

Nakabo, Ayumi ^{[2
]}

Ichiryu, Hajime ^{[2
]}

Endo, Susumu ^{[2
]}

Hayashi, Misayo ^{[2
]}

Naruse, Genki ^{[2
]}

Nakayama, Juri ^{[1
]}

Takada, Ayae ^{[1
]}

Fujimoto, Shingo ^{[1
]}

Ozawa, Noriko ^{[1
]}

Inada, Takayuki ^{[1
]}

Nohisa, Yuzuru ^{[1
]}

Kikuchi, Ryosuke ^{[1
]}

Kanamori, Hiromitsu ^{[2
]}

Okura, Hiroyuki ^{[1
,2
]}

机构：

[1] Gifu Univ Hosp, Div Clin Lab, Gifu, Japan

[2] Gifu Univ, Grad Sch Med, Dept Cardiol, Gifu, Japan

[3] Gifu Univ, Gifu Univ Hosp, Dept Cardiol, Div Clin Lab,Grad Sch Med, 1-1 Yanagido, Gifu, Gifu 5011194, Japan

来源：

JOURNAL OF CARDIOLOGY | 2024年 / 83卷 / 06期

关键词：

Left ventricular outflow obstruction; Doppler; Echocardiography; Cardiomyopathy; TAKOTSUBO CARDIOMYOPATHY; CLINICAL CHARACTERISTICS; PRESSURE-GRADIENT; SEPTAL BULGE; PREVALENCE; DIAGNOSIS; SOCIETY;

D O I：

10.1016/j.jjcc.2023.11.006

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Left ventricular outflow tract obstruction [LVOTO; pressure gradient (PG) >= 30 mmHg] is observed in some patients without hypertrophic cardiomyopathy (HCM), and it may develop especially in older patients without HCM (non-HCM). The aim of this study is to investigate if the Valsalva or an upright sitting maneuver can unveil latent LVOTO in patients with non-HCM. Methods: A total of 33 non-HCM patients with a late peaking or dagger-shaped pulsed Doppler waveform of the LVOT and PG <30 mmHg were included. The Doppler flow velocity of the LVOT was measured at rest, after the Valsalva and a sitting maneuver. Peak PG of >= 30 mmHg after either maneuver was defined as latent LVOTO. The angle between the left ventricular septum and the aorta in the parasternal long-axis view and the apical three-chamber view was measured. Results: Twenty (61 %) of the 33 patients (mean age 74 +/- 9 years) were diagnosed with latent LVOTO. Of these, five (25 %) patients were diagnosed after both the Valsalva and sitting maneuver, and 15 (75 %) were diagnosed only after the sitting maneuver. The latent LVOTO group had a significantly smaller angle than the no-LVOTO group between the ventricular septum and the aorta in the parasternal long axis views (107 +/- 8 degrees vs. 117 +/- 8 degrees, p < 0.01). Conclusion: The sitting maneuver is better than the Valsalva maneuver in unveiling latent LVOTO in older, non-HCM patients. (c) 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

引用

页码：401 / 406

页数：6

共 31 条

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