BACKGROUND We previously reported that 6 to 12 weeks of dual-chamber (DDD) pacing results in clinical and hemodynamic improvement in obstructive hypertrophic cardiomyopathy (HCM). This study examines the long-term results of DDD pacing in obstructive HCM. METHODS AND RESULTS DDD devices were implanted in 84 patients (mean age, 49 +/- 16 years) with obstructive HCM and severe drug-refractory s...

Sigmoid-shaped interventricular septum (SIS) is not uncommon in elderly patients and is considered a normal part of the aging process. However, several patients have been reported to have clinical symptoms due to the narrowing of the left ventricular outflow tract (LVOT). Two patients with SIS presented with recurrent episodes of syncope after drinking or taking sublingual nitroglycerin (NG). I...

Background Alterations in systolic blood flow are a characteristic finding in patients with obstructive hypertrophic cardiomyopathy (HCM). Echocardiography is the gold standard for hemodynamic assessment in HCM, but this technique is generally limited to measurement of the left ventricular outflow tract (LVOT) pressure gradient and may not provide a complete description of the hemodynamic impac...

Hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow tract (LVOT) obstruction (those with a gradient of > 100 mm Hg) are at the highest risk of hemodynamic deterioration during pregnancy. Complications of HOCM include sudden cardiac death, heart failure, and arrhythmias. Physiological changes during pregnancy may induce these complications, affecting mate...

Systolic anterior motion (SAM) of mitral valve is the prolapse of a mitral leaflet into the left ventricle outflow tract (LVOT) during systole, causing LVOT obstruction and mitral valve regurgitation. We report the case of a patient who developed SAM-induced hemodynamic instability during bleeding with a clinical picture resembling pulmonary edema. A 77-year-old woman was admitted to our emerge...

Analysis of a tapering, pulsatile flow field predicts that substantial subvalvular pressure gradients exist in patients with valvular aortic stenosis (AS) without invoking a second anatomic site of obstruction. Using a catheter with two laterally mounted micromanometers, we examined the left ventricle in 11 patients with AS, mean age 64 +/- 11 years (+/- SD); the mean valve area was 1.0 +/- 0.3...

Abstract Background Early diagnosis of cardiac amyloidosis (CA) is warranted to initiate specific treatment and improve outcomes. Conventional echocardiography unable reliably differentiate CA from other causes increased left ventricular (LV) wall thickness. Purpose To demonstrate the value a multiparametric approach utilising both standard advanced echocardiographic measures distinguish pathol...

We sought to validate measurement of intraventricular pressure gradients (IVPG) and analyze their change in patients with hypertrophic obstructive cardiomyopathy (HOCM) after ethanol septal reduction (ESR). Quantitative analysis of color M-mode Doppler (CMM) images may be used to estimate diastolic IVPG noninvasively. Noninvasive IVPG measurement was validated in 10 patients undergoing surgical...

OBJECTIVES We report the acute results and midterm clinical course after percutaneous transluminal septal myocardial ablation (PTSMA) in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). BACKGROUND In the treatment of HOCM, surgical myectomy and DDD pacemaker therapy are considered the standard procedural extensions to drug therapy with negatively inotropic drugs. As a...