Doppler echocardiographic assessment of the pressure gradient during bicycle ergometry in hypertrophic cardiomyopathy
| Autor: | Michael Block, Ehud Schwammenthal, Bodo Schwartzkopff, Günter Breithardt, M. Borggrefe, Lösse B, Jan Johns, Rolf Engberding |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac Catheterization Systole medicine.medical_treatment Physical Exertion Hemodynamics Physical exercise Blood Pressure Doppler echocardiography Ventricular Function Left Ventricular Outflow Obstruction Heart Rate Internal medicine medicine Humans Cardiac Output Pressure gradient Cardiac catheterization Aged medicine.diagnostic_test business.industry Hypertrophic cardiomyopathy Stroke Volume Blood flow Cardiomyopathy Hypertrophic Middle Aged medicine.disease Echocardiography Doppler Blood pressure cardiovascular system Cardiology Exercise Test Mitral Valve Female Vascular Resistance Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
| Zdroj: | The American journal of cardiology. 69(19) |
| ISSN: | 0002-9149 |
| Popis: | To assess the behavior of the subvalvular pressure gradient under physical exercise, 13 patients with obstructive hypertrophic cardiomyopathy were examined during upright bicycle ergometry by means of Doppler echocardiography. Additionally, right-sided cardiac catheterization was performed within 7 days. In 10 patients adequate Doppler tracings could be obtained during exercise. The Doppler-derived systolic pressure gradient increased from 75 +/- 24 to 140 +/- 42 mm Hg (p less than 0.0005). This was associated with an increase in the duration of the systolic mitral-septal contact from 59 +/- 21 to 136 +/- 28 ms (p less than 0.0005). Correlation between the pressure gradient and the duration of mitral-septal contact at rest and during exercise was good (r = 0.86), whereas correlation between the resting and exercise pressure gradient (r = 0.34) did not reach statistical significance. The increase in stroke volume during exercise, from 90 +/- 18 to 95 +/- 24 ml, was significant (p less than 0.05) but minimal. Therefore, only a moderate increase in systolic flow, from 205 +/- 54 to 268 +/- 78 ml/s (p less than 0.0005), was observed. Outflow tract resistance, defined as the ratio of the pressure gradient to systolic flow, increased from 0.38 +/- 0.11 to 0.57 +/- 0.24 mm Hg.s/ml (p less than 0.01). Thus, in a selected group of patients with hypertrophic cardiomyopathy a substantial increase in the maximal pressure gradient during upright bicycle ergometry was demonstrated in most patients. Exercise Doppler echocardiography may be valuable to assess the hemodynamic significance of obstruction in individual patients in a physiologic setting and has a potential to monitor the effect of therapeutic interventions. |
| Databáze: | OpenAIRE |
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