Characterize Left Ventricular Outflow Obstruction in Hypertrophic Cardiomyopathy
Posted by James
“Datients with hypertrophic cardiomyopathy (HCM) may be categorized according to the presence and severity of left ventricular outflow tract obstruction (LVOTO). Such a classification identifies three hemodynamic subsets: absence of LVOTO, resting LVOTO, and latent or provocable LVOTO, all of which may have different therapeutic and prognostic significance. Continuous wave Doppler combined with 2-D and M-mode echocardiography offers a useful means by which to identify these hemodynamic subsets. Although inhalation of the vasodilator, amyl nitrite (Amyl), has long been recognized as a means to provoke latent LVOTO in patients with HCM, the value and safety of Amyl in patients undergoing ambulatory Doppler echocardiography has not been studied in a systematic fashion. The purpose of this study was to characterize the nature and severity of LVOTO in a consecutive series of patients referred for evaluation of clinically suspected HCM using Doppler echocardiography, and in selected instances, in combination with Amyl inhalation.
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